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Putting Communities First: Reflections on IAPB’s South East Asia Regional Meeting

Published: 16.09.2022
Dr. Troy Cunningham Country Director
Operation Eyesight India
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Eye health care cannot be comprehensive or responsive without first addressing the needs and structural barriers that exist within the community.

Addressing people’s socio-economic barriers is at the core of a successful health care system, as care delivered in the community happens alongside a host of socioeconomic factors and forces, including existing health systems. Understanding the unique needs, preferences and values of individuals and communities is a key part of what it means to be ‘people-centred,’ or better yet, ‘person-centred.’

Clinical eye care services are one piece in this much larger puzzle. For me, there were two key takeaways from IAPB’s recent South East Asia Regional Meeting, focused on implementing Integrated People-centred Eye Care (IPEC). First is the importance of measuring the ‘effective cataract surgery’ and ‘effective refractive error’ conversion indicators. These are high-level measures to assess the success of delivery of quality eye care services.

The second takeaway is the power of partnership in achieving IPEC’s vision.

The range of presentations and experts that our team was able to engage with highlighted the immense potential for knowledge sharing and collaboration, as we all work towards a shared vision for global healthcare that includes eye health care.

IPEC, a key recommendation of the World Health Organization’s 2019 World Report on Vision, is the focus of the global eye health sector. IPEC has also been a key part of Operation Eyesight’s approach for decades, enabling us to reach the unreached. Our focus on empowering communities and building the capacity of partners is allowing us to strengthen health systems in all of our countries of work – Bangladesh, Ethiopia, Ghana, India, Kenya, Liberia, Nepal and Zambia.

‘Integrated’ eye care is care that is part of the local health system. This often requires partnership with hospitals and staff and often means utilizing local health resources, personnel and infrastructure. ‘People-centred’ means focusing on the needs, preferences and values of individuals and communities.

This focus on people who are at the core of all our interventions – the community connection – has been a driving force behind Operation Eyesight’s work to open local vision centres, recruit local health workers who are predominantly women (90%) and conduct door-to-door screenings. This ensures that we leave no one behind, especially girls and women. This translates into empowered communities that can care for their own health and our success in eliminating avoidable blindness. What is unique about our approach is it strengthens health systems ‘from the bottom, up’ – starting at people’s front doors.

Eye health care exists on a continuum, from the community, to partner facilities, back to communities for rehabilitation and follow-up care. Therefore, we have also focused on training existing healthcare staff, investing in infrastructure and creating referral networks with partner facilities and hospitals.

Eye Care and the Sustainable Development Goals

In addition to showcasing Operation Eyesight’s IPEC work, I was particularly pleased to collaborate in panel discussions and Q&A sessions focused on the relationship between the UN’s Sustainable Development Goals (SDGs) and eye health. The connection between the SDGs and eye health is a clear one, and this is confirmed by the experience of our teams in the field.

When our teams conduct post-surgery visits and evaluation surveys, we see evidence of family breadwinners who have been able to restart their small businesses and provide for their families. We see senior citizens who have returned to their caregiver role, supporting their grandchildren’s education and nutrition.

The Regional Meeting highlighted the need to build evidence of eye health services’ attribution to achieving several SDGs. For example, our teams often encounter people with vision loss who suffer from other health conditions, and our teams play a pivotal role in helping patients access health services in their locality. In Zambia, we are seeing how the presence of a borehole in a community helps girls attend school because they no longer have to haul water long distances for their families.

Integrating eye care within the public health system connects our work with what’s happening at the grassroots level, through the public health system. This also keeps our project teams informed about the needs of communities.

The Power of Partnership

So many organizations have so much to offer, and that’s why partnership is more important than ever to make IPEC a reality.

IPEC means more than just eye health for communities; it’s directly linked to good health and well-being, quality education and economic growth.

IAPB members’ collective knowledge, experience and expertise are what will make IPEC’s vision of focusing on integrating care and responding to the needs of people a reality.

Image on top: After Chiri, from the village of Thankot, Nepal, was diagnosed with cataracts, one of our community health workers helped Chiri get her blood sugars and diabetes stabilized before she could receive sight-restoring surgery at our
partner hospital, Nepal Eye Hospital.