Case Study of Project Addressing Inequity

Sumrana Yasmin

• Equity is about bridging gaps• Collective strength of all stakeholders

Right to Health Care • Rights are universal; apply to rich and poor;

men and women; adults and children in all settings

• Huge inequity is evident - minimum levels of care being unavailable

• Influencing factors:• Health policies; economic structures; urban rural

divide; living and working conditions; cultural, social and community influences; and gender

Low Vision - Coverage• Less than 5% in Asia• Less than 1% in Africa• Better in Europe, Australia and USA but

still less than 30%• Both a cause and consequence of poverty• Geographical coverage!• Concerted efforts - interventions directed

towards the reduction of inequity

Sri Lanka – National Low Vision Program

• Started in 2003 - Provision of quality and effective clinical and rehabilitation services

• NLVP was launched in 2007 by MoH and supported by Sightsavers and Brien Holden Vision Institute

• To develop LV care as part of CEC and create the necessary linkages with other services i.e. education, rehabilitation and social services

• Significant progress has been made• Ten secondary level clinics• Linked to the four tertiary clinics• Three LV resource centres • 7,749 (877, 11% children) have received low

vision services • Approx. 5 folds increase in last 5 years• Number is incrementally increasing

Sri Lanka – National Low Vision Program

Sri Lanka – National Low Vision Program

• Cross-referral within clinical, education, and rehab/disability services

• Foundation for scale up• Next phase focus:

• Integration of LV into CBR program• Engagement with MoE• Addition of LV services

into VCs• Self-help groups

Addressing inequity• Ownership• HSS is the foundation • LV services at district hospitals and

are easily accessible• Free provision of spectacles

and LVDs• Awareness about the services

is trickling down from health professional to educators to communities

Strategies • Strategies will vary - there are some principles

that apply across• Include comprehensive low vision care in

national eye health plans• Cross-sectoral collaboration

• Health, education, rehabilitation, social services• Innovative partnerships at various levels

• Policy• Planning and implementation

Strategies • Create peer support groups

and role model• Lead to enabling environment

for quality inclusive systems• Promote equity and equality • Ensure that we reach the

un-reach