title cluster based planning for elimination of avoidable blindness (rajganj block, jalpaiguri...

TITLE CLUSTER BASED PLANNING

FOR

ELIMINATION OF AVOIDABLE BLINDNESS

(Rajganj Block, Jalpaiguri district, West Bengal)

Presenter :-Anup ZimbaSiliguri Greater Lions Eye HospitalSiliguri, West Bengal, India

SILIGURI GREATER LIONS EYE HOSPITAL


PARTNERS :-

Comprehensive OphthalmologyVitreo Retina

Pediatric Ophthalmology & SquintGlaucoma / Oculoplasty

Low Vision Clinic / Contact LensTele-ophthalmology

B.Sc. OptometryVision Technician

Ophthalmic assistant

Established :1981Beds : 54OPD : 888,817 Surgery : 85,437 Outreach Screening : 483,095 School Screening : 1,663,398


Hospital Catchment area

Vision

“SGLEH’s vision is to be Centre of Excellence to provide quality eye care services for all”

Mission

“SGLEH is a public trust committed to provide excellent, affordable eye care services through dedicated team work and

making it accessible to all in Eastern part of India.”

Objective To assess the role of cluster based community eye health planning in eliminating

avoidable blinding causes with the help of a secondary level hospital.

To improve eye health seeking behavior of the target population

To strengthen primary health services

To integrate primary eye care services with primary health care services

Improved utilization of eye care services leading to elimination of avoidable

blindness

HOSPITAL BASED COMMUNITY EYE HEALTH PROGRAMME(HBCEHP)

Supported by Operation Eyesight


Cluster formation o Division of clusters :

- Each cluster has 20,000-22,000 population - Geographical area - Population distribution

o Field staff trainees selection• 2 trainees per cluster• Priority to women candidates• Previous experience• Good communication skills • Local people to given preference

Project area/ cluster formation


Based on Number of blind persons identified through door to door survey Number of persons with cataract (bilateral & unilateral) Number of persons with other eye diseases Current levels of knowledge, attitude and practices among the

cluster population

Number of persons with other eye diseases Number of screening Programme required to be conducted Number of eye health/ general health education events Number of NGOs present in the cluster Number of ICDS/ PHC centers and staff

Development of cluster plans

• Project started in July 2010

• 14 candidates underwent 23 days training.

• Door to door survey covering 1,04,327 persons.• 320 villages covered.• Survey period 3 months (Sep ‘10-Nov ‘10).

• Eye care services provided by Field Staffs• Screening • Diagnosis, referral• Treatment • Follow up• Health education

•Coordination with government agencies for • Immunization• ANC/ PNC

•Socio economic development • Networking with other agencies

The process


Training : Curriculum developed by OE First module

Identifying blind persons and person with eye diseases

Survey methodology Second module training

Curriculum developed by OE All the trainee workers attend PHC services Networking Implementation of eye health

services

Door to door survey Conducted over 3 months Covers the entire population of the

selected area (all clusters) The survey focuses on identification of

visually impaired persons with special emphasis on identification of persons with cataract and refractive errors

Computerization of all collected data for further analysis

Training and survey


Community Eye Care: Screening programmes in each cluster

Eye check up Treatment for minor ailments Referral for further management to the

base hospital.

Primary eye care centers (vision centers)

Health promotion/education activities

Training of self help groups in eye care

Implementation of cluster plans


Primary Health Care and Community Development Maternal and child health care Immunization Vitamin A Micro-skill development Primary and non formal education Water and sanitation Referral for community based rehabilitation

Implementation of cluster plans


Daily wage workers Seasonal fluctuation Drop outs of health workers Capacity building of new recruits Weather

Challenges


Eye care (Jan 2011-July 2012) Total Camp: 76 Total Screened: 9,398 Total Advised for Cataract Surgery: 1,456 Total cataract operated: 1,186 (81%) Total Specs Advised: 1,265 Total Specs uptake: 833 (66%) Total People educated for Health Education: 39,015 Total network with local NGO/Govt: 19

Surgery

70% Free

20% Subsidized

10% Paying/RSBY

Outputs

Services 1 2 3 4 5 6 7 Total

Identified patients •Blind•Uni. & Bil-cataract •Others

6077571

9334381`

155556105

21938863

86462109

68256116

126323199

8073103663

Operated 140 200 201 168 160 192 247 1,308

Spectacles provided 106 103 107 109 108 104 105 833

Balance patients 706 143 460 283 411 180 275 2458

Eye health education 6,140 6,486 6,065 6,421 5,876 5,966 6,693 39,015

Immunization coverage Two years back 69.7% *Now 80%

Surgical conversion 81%

Spectacle conversion 66%

Results

* Singapore Med J 2010; Socioeconomic impact on child immunization in the districts of West Bengal, India

Immunization Rally by Children on Eye care Sanitation demo

Health Awareness

Health camp Training ICDS workers

Meeting with NGOs

Public awareness

Project Activities


SummaryCluster based planning brings: Services right at the door steps of the needy Ensures treatment of identified Increases positive behavioural change


1. Establish a Vision Center.2. Expansion of project catchment area.3. Implement similar program in other Blocks.4. Identify potential donors for supporting the project

in other blocks.

Future programs


Cluster based planning is proving to be an effective approach to elimination of avoidable blindness.

Brings permanent and positive change in eye health seeking behavior in Rajganj block before the end of the project(2014).

CONCLUSIONS

THANK YOU

title cluster based planning for elimination of avoidable blindness (rajganj block, jalpaiguri...

Documents

primary eye care services

affordable eye care

quality eye care services

community eye health

eye health seeking behavior

hospital distance

primary health care

primary health services