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Integrated people centred eye care, at its outset places people at the centre of health care. While the straightforward concept of IPEC is integration into health system and making services people centred, it also brings services in the hands of the people.
IPEC recognizes people as participants and beneficiaries of eye care services. In practice, implementation of this concept would actively involve people or the service receivers in the decision making of their health care choices. Implementation of IPEC becomes worthwhile when it is inclusive, reaches the most deprived and needy in the community and minorities including the indigenous people.
In 2020, a staggering 90% of all unaddressed blindness and vision impairment is in low- and middle-income countries, with the poor and extreme poor among the furthest left behind. Women and girls (55% of vision loss), older persons (74% are aged over 50 years old) as well as persons with disabilities, indigenous peoples, refugees and internally displaced persons and migrants are among those most affected. Increased efforts aimed at reaching those furthest left behind and to target the immediate factors driving the vast inequities which exists in eye health (geographical accessibility, acceptability, cultural, socioeconomic) is a critical component of IPEC.
IPEC is critical for equity in accessing care. Eye care services are often provided in secondary or tertiary hospitals based in urban centres, inaccessible to large swathes of the population, especially the most vulnerable. IPEC tackles this situation by shifting balance of care so that resources are closer to patients at the community and primary care level with clear referral pathways for specialist diagnoses and treatments.
One of the four major strategies of the implementation of IPEC, recommended by the WHO World Report on Vision 2019, is empowering and engaging people and communities. In order to achieve the aims of IPEC, i.e., improved service delivery, care experiences and outcomes, people should be empowered as effective users and beneficiaries of eye health services. This should continue throughout all stages of their lives and as their health needs change.
Eye health has also been recognised and established as enabler to achieving sustainable development goals in the United Nations General Assembly Resolution. The UNGA resolution A/75/L.108 on ‘Vision for Everyone, accelerating action to achieve the Sustainable Development Goals’ made clear that the realization of ‘Vision for Everyone’ will make a crucial contribution to the 2030 Agenda, help achieve sustained, inclusive and equitable economic growth and development and ensure that no one is left behind. Therefore, eye health is critical if we are to leave no one behind.
In line with the commitment to the resolution, IPEC itself is a people centred approach with inclusion as its major principle, to deliver eye care services which are integrated into the health system of the country. This shows that IPEC is critical to ensure that the world’s indigenous people receive appropriate eye care. So, while observing the International Day of the World’s Indigenous Peoples, this year lets advocate for IPEC- putting the indigenous eye care at the centre.
Image on top: Explaining Vision Testing to an old woman during a Village Screening. FHFNZ, Papua New Guinea/ Theresa Gende