Transcript Dr Padnaja Kumari Rani_ Integrating Primary eye care and primary

Integrating Primary Eye Care
and
Primary Health Care
17th Sept 2012
Dr Padmaja Kumari Rani,M.S,FNB (Retina)
Head, Village Vision Complex
International Centre for Advancement of Rural Eye Care (ICARE)
L V Prasad Eye Institute
Hyderabad
PEC PHC
Acknowledgement:Puwat Charukamnoetkanok, MD, Thailand
PEC PHC
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Integrating
Primary Eye Care
and
Primary Health Care
Why
What
How
Global Scenario – Thailand Case Study
Indian Scenario (OEU & LVPEI Case studies)
Challenges
Way forward
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Why?
• Holistic care
• Treating causes of causes
• Wide reach
• Sustainability
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What?
W
H
O
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What?
• Horizontal approach
• Team work
• Networking
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What?
W
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O
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How?
• Location
• Areas of Integration
• Stake holders
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How?
Khan et al
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Global scenario-Thailand
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Global scenario-Thailand
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Global scenario-Thailand
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Indian scenario – OEU
Operation Eye Sight Universal – India
• Launched in 1963
• 15 Projects
• 11 Partners
HBCEHP –
USEHP –
OE India -
• 9 States & UT
• 3.4 million - people
covered
• 0.75 million – persons
directly benefited
•Immunization coverage
•ANC/ PNC coverage has
reached 100%
•Increased Awareness levels
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Indian scenario – LVPEI
To eliminate avoidable blindness through
integration of Primary eye care with Primary health
care by community Development Initiatives.
Who is a Vision health guardian
•Local village person
•Literate
•Healing touch
•Health worker background
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LVPEI (2010-2012)
• One tiny Village (5 months) – n-746
• Mandal ( District Subunit) – 54 villages with
(2011-14) n-39,000
• Present Coverage – 70 villages -n-100,000
Methodology
i. Identification and Training of Village Vision
Health Guardians
i. Awareness creation
ii. Service delivery
iii. Community Development Initiatives
Methodology
I . Identification and Training of Village Vision Health
Guardians and village vision committee formation
Methodology
II. Awareness creation
Teachers Training Program
Teacher conducting Eye screening
Methodology
III. Service delivery
Methodology
IV: Community Development Initiatives
JSS trade training program inauguration
JSS trade training program in house wiring and electrical maintenance for
village youth
Vision Garden Inauguration
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Coverage of One Mandal -54 Villages
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Situational Analysis of Study area
Illiteracy in Jainad Mandal
% of population below poverty line
39.45 % - very low in females
>26%
Pattern of agriculture
Dry crops / irrigated dry crops cultivation due to
lack of perennial source of irrigation
Infrastructure
Poor Drainage / Sanitation / Power supply, roads
etc.,
Employment opportunities
Meager, due to lack of industries or arable lands
and low scope for self employment
Type of houses
Gas connection
50% Semi pucca
30%
Individual toilets attached to houses
26%
Average percapita annual income
Rs 29,187/GDP : 8,786 crores [2007-2008]
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Project Survey Data
Slums/Villages surveyed
Houses surveyed
54
9,538
Population covered through door to door survey
38,829
Diabetes high risk [score>60]
Known diabetics identified (2.5%)
Known Hypertension (3.4%)
Identified with High BP > 140/90 by VHG
Identified with disability [All category]
People identified with eye ailments and referred
for eye examination
56
1,006
1106
221
103
2,740
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Project Survey Interim Data
Blindness (<6/60)-0.4%
Visual Impairment (<6/18)-7.1%
Spectacles prescribed- 664
Spectacles Purchased-354 (53%) children-35
Cataract Identified – 771
Patients visited SC-491
Cataract surgeries done-122
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Project Survey Interim Data
• Eye health and Primary health education
events conducted -363
• n-2,877
• Number of pregnant women in the covered
villages - 408
• Antenatal care-408 , Postnatal care-140
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Qualitative Impact
Master SaiKumar
Three VHGs – enrolled as Vision technicians
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Challenges
• Slow Process
• Linkage with health care providers
• Understanding Motivators/Barriers for
performance of VHGs
• Measuring the Impact
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Way forward
• Cost effective Technology Innovations
• Care of the Community, by the Community
and for the Community
“Thousands of candles can be lit from a single
candle, and the life of the candle will not be
shorter. Happiness never decreases by being
shared.”
The Buddha
Thank you!
L V Prasad Eye Institute
www.lvpei.org
Excellence
Equity
Efficiency