Advocacy to Action – Stories from the regions – Ghana

Shaping Ghana’s eye care landscape – the journey of collaboration  

Amidst the difficulties in Ghana, this initiative sets an inspiring example of eye care advocacy. Adopting the public-private partnership approach, they used evidence though a survey to bolster their advocacy efforts such as reducing the prices of Glaucoma medications. Despite the challenges, an impact was made, and it becomes an inspiring story of success. It is also an instance of making this sustainable through a network of stakeholders.  This instance exemplifies some of the key aspects of successful advocacy from the “Advocacy for Eye Health: A Beginner’s Guide” such as use of scientific evidence to bolster credibility, inclusiveness, and enhancing the project’s resilience.  

Background 

In 2020 in Ghana, their crude prevalence of blindness was estimated to be 0.32% according to VLEG.1 . There was a dearth of critical evidence that can inform advocacy priorities and a need emerged to conduct a population-based national survey. A well planned and executed public private advocacy model resulted in compelling evidence for the government to take action However, the budget to conduct such a survey was beyond the reach of only one organization.   

The global eye health action plan 2014–2019 aimed to reduce avoidable visual impairment as a global public health problem and to secure access to rehabilitation services for the visually impaired.  The 3 objectives recommended are:   

• The need for generating evidence on the magnitude and causes of visual impairment and eye care services and using it to monitor progress, identify priorities and advocate for greater political and financial commitment by Member States to eye health. 
• The development and implementation of integrated national eye health policies, plans and programmes to enhance universal eye health with activities in line with WHO’s framework for action for strengthening health systems to improve health outcomes. 
• The multi-sectoral engagement and effective partnerships to strengthen eye health. 

To generate evidence, we set out to conduct a national blindness and visual impairment survey to know where we are with several years of investments and service provision.

Strategy  

We approached several partners but only one agreed to partner with us, despite the fact that each and everyone thought it was a brilliant idea and a very useful initiative.  Then the third objective came to mind. “The multi-sectoral engagement and effective partnerships”. We decided to use the Public Private Partnership (PPP) approach which worked. 

Engaging stakeholders 

Our approach on the PPP model made government agencies, private sectors, non-governmental organizations our stakeholders in the project. In this mode of engagement, we worked with  

1. Government agencies:

• The Ministry of Health through the Ghana Health Service supported in “kind” – Seconding Ophthalmologists, Optometrists. Ophthalmic Nurses for the entire period of the survey. The Ministry also released vehicles for the use of the research teams for the entire period of the survey. 
• The Ghana College of Physicians and Surgeons faculty of Public Health – Study design, ethical clearance, monitoring, and final report writing. 
• The Ghana Statistical Services – seconded staff to assist in the statistical calculations and analysis of the data.  

2. Private Sector
 The Standard Chartered Bank through the Seeing is Believing project provided some financial support. 

3. Non-Governmental Organizations
 Swiss Red Cross and Operation Eyesight Universal also provided some funding as well. 

Impact  

The impact of this was phenomenal.   

The results of the survey triggered these benefits. (See Table below) 

Lessons Learned  

1. Always think outside the box: We in the Ophthalmic space have always stayed within our circle.  Let us try to go out and seek like-minded groups who will be interested to help achieve a common goal. 
2. Roles and Responsibilities: There has to be an agreement/memorandum of understanding clearly setting out the roles and responsibilities of each partner. 
3. Active engagement: Active engagement of all Stakeholders is very key to success.  
4. Cost-effectiveness:    With such an approach the cost to each stakeholder becomes affordable. 
5. Where there is a will, there is always a way: It was going to be very easy to give up looking at the budget involved.  But we saw the need for such a project, and it has had a ripple effect. 

Authored by Dr Boateng Wiafe, Technical Advisor, Operation Eyesight Universal