Integrating Primary Eye Care and Primary Health Care

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Integrating Primary Eye Care and Primary Health Care 17 th Sept 2012 Dr Padmaja

Integrating Primary Eye Care and Primary Health Care 17 th 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

PEC PHC Acknowledgement: Puwat Charukamnoetkanok, MD, Thailand

PEC PHC Acknowledgement: Puwat Charukamnoetkanok, MD, Thailand

PEC PHC • • • Integrating Primary Eye Care and Primary Health Care Why

PEC PHC • • • Integrating Primary Eye Care and Primary Health Care Why What How Global Scenario – Thailand Case Study Indian Scenario (OEU & LVPEI Case studies) • Challenges

PEC PHC Why? • Holistic care • Treating causes of causes • Wide reach

PEC PHC Why? • Holistic care • Treating causes of causes • Wide reach • Sustainability

PEC PHC What? W H O

PEC PHC What? W H O

PEC PHC What? • Horizontal approach • Team work • Networking

PEC PHC What? • Horizontal approach • Team work • Networking

PEC PHC What? W H O

PEC PHC What? W H O

PEC PHC How? • Location • Areas of Integration • Stake holders

PEC PHC How? • Location • Areas of Integration • Stake holders

PEC PHC How? Khan et al

PEC PHC How? Khan et al

PEC PHCGlobal scenario-Thailand

PEC PHCGlobal scenario-Thailand

PEC PHC Global scenario-Thailand

PEC PHC Global scenario-Thailand

PEC PHC

PEC PHC

PEC PHC Global scenario-Thailand

PEC PHC Global scenario-Thailand

PEC PHCIndian scenario – OEU Operation Eye Sight Universal – Ind • Launched in

PEC PHCIndian scenario – OEU Operation Eye Sight Universal – Ind • Launched in 1963 • 15 Projects HBCEHP – USEHP – OE India - • 11 Partners • 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

PEC PHC Indian scenario – LVPEI To eliminate avoidable blindness through integration of Primary

PEC PHC 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

Who is a Vision health guardian • Local village person • Literate • Healing touch • Health worker background

LVPEI (2010 -2012) PEC PHC • One tiny Village (5 months) – n-746

LVPEI (2010 -2012) PEC PHC • 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.

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

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 II. Awareness creation Teachers Training Program Teacher conducting Eye screening

Methodology III. Service delivery

Methodology III. Service delivery

Methodology IV: Community Development Initiatives JSS trade training program inauguration JSS trade training program

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

PEC PHC Coverage of One Mandal -54 Villages

PEC PHC Coverage of One Mandal -54 Villages

PEC PHC Situational Analysis of Study area Illiteracy in Jainad Mandal % of population

PEC PHC 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]

PEC PHC Project Survey Data Slums/Villages surveyed Houses surveyed 54 9, 538 Population covered

PEC PHC 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

PEC PHC Project Survey Interim Data • • Blindness (<6/60)-0. 4% Visual Impairment (<6/18)-7.

PEC PHC 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

PEC PHC Project Survey Interim Data • Eye health and Primary health education events

PEC PHC 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

PEC PHC Qualitative Impact Master Sai. Kumar Three VHGs – enrolled as Vision technicians

PEC PHC Qualitative Impact Master Sai. Kumar Three VHGs – enrolled as Vision technicians

PEC PHC Challenges • Slow Process • Linkage with health care providers • Understanding

PEC PHC Challenges • Slow Process • Linkage with health care providers • Understanding Motivators/Barriers for performance of VHGs • Measuring the Impact

PEC PHC Way forward • Cost effective Technology Innovations • Care of the Community,

PEC PHC 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

“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 Excellenc Equity Efficiency

Thank you! L V Prasad Eye Institute www. lvpei. org Excellenc Equity Efficiency

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