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TITLE CLUSTER BASED PLANNING FOR ELIMINATION OF AVOIDABLE BLINDNESS (Rajganj Block, Jalpaiguri district, West Bengal) Presenter :Anup Zimba Siliguri Greater Lions Eye Hospital Siliguri, West Bengal, India Established Beds OPD Surgery Outreach Screening School Screening :1981 : 54 : 888,817 : 85,437 : 483,095 : 1,663,398 Comprehensive Ophthalmology Vitreo Retina Pediatric Ophthalmology & Squint Glaucoma / Oculoplasty Low Vision Clinic / Contact Lens Tele-ophthalmology B.Sc. Optometry Vision Technician Ophthalmic assistant PARTNERS :SILIGURI GREATER LIONS EYE HOSPITAL SILIGURI GREATER LIONS EYE HOSPITAL 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.” SILIGURI GREATER LIONS EYE HOSPITAL 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 Cluster formation oDivision of clusters : - Each cluster has 20,000-22,000 population - Geographical area - Population distribution oField staff trainees selection • 2 trainees per cluster • Priority to women candidates • Previous experience • Good communication skills • Local people to given preference SILIGURI GREATER LIONS EYE HOSPITAL 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 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 SILIGURI GREATER LIONS EYE HOSPITAL the SILIGURI GREATER LIONS EYE HOSPITAL • 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 Training : Curriculum developed by OE Door to door survey First module Conducted over 3 months 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 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 SILIGURI GREATER LIONS EYE HOSPITAL 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 SILIGURI GREATER LIONS EYE HOSPITAL 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 SILIGURI GREATER LIONS EYE HOSPITAL Daily wage workers Seasonal fluctuation Drop outs of health workers Capacity building of new recruits Weather SILIGURI GREATER LIONS EYE HOSPITAL 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 SILIGURI GREATER LIONS EYE HOSPITAL Services 1 2 3 4 5 6 7 Total Identified patients •Blind •Uni. & Bil-cataract •Others 60 775 71 93 343 81` 155 556 105 219 388 63 86 462 109 68 256 116 126 323 199 807 3103 663 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% * Singapore Med J 2010; Socioeconomic impact on child immunization in the districts of West Bengal, India Immunization Rally by Children on Eye care Health Awareness Health camp Sanitation demo Meeting with NGOs Training ICDS workers Public awareness Cluster based planning brings: Services right at the door steps of the needy Ensures treatment of identified Increases positive behavioural change SILIGURI GREATER LIONS EYE HOSPITAL 1. 2. 3. 4. Establish a Vision Center. Expansion of project catchment area. Implement similar program in other Blocks. Identify potential donors for supporting the project in other blocks. SILIGURI GREATER LIONS EYE HOSPITAL 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). SILIGURI GREATER LIONS EYE HOSPITAL