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On 22 December 2021, the Ministry of Health in Malawi launched the national guidelines for diabetic eye care and the national guidelines for glaucoma eye care. The guidelines were developed to provide evidence-based clinical guidance for the management of diabetic retinopathy and glaucoma in the country. They were adapted from the guidelines for diabetic eye care and guidelines for glaucoma eye care developed by the International Council of Ophthalmology (ICO).
Following the launch of the guidelines, the assistant director responsible for ophthalmology in the Ministry of Health, Mr. Michael Masika, expressed pleasure with the publication and dissemination of the guidelines. He commented on the guidelines for glaucoma mentioning that although glaucoma is the second-leading cause of blindness in Malawi, there remain alot of gaps in the health system with respect to glaucoma care and that the guidelines are an important step towards addressing those gaps.
Dr. Jones Kaponda Masiye, the deputy director of clinical services in the Ministry of Health said “Traditionally, the Ministry of Health focused more on infectious diseases of public health importance in Malawi such as HIV/AIDS, malaria and TB. Since 2011, there has been an increasing focus by the Ministry on Non-Communicable Diseases (NCD) due to the rising burden of NCDs. The guidelines on diabetic eye care are an important tool for ensuring comprehensive diabetes care for patients across the country. Thus, they are a crucial element in the control of NCDs in the country”.
Lack of national guidelines for diabetic retinopathy and glaucoma were priority gaps that were identified following national situational analyses that were carried out in 2020 on diabetes care, diabetes eye care and glaucoma services in Malawi. The situational analyses and subsequent development of both guidelines were locally-led by Dr Shaffi Mdala, Dr Thokozani Zungu and Dr Petros Kayange from the Ophthalmological Society of Malawi (OSM) with funding from Lions Clubs International Foundation (LCIF). Dr Silvio Paolo Mariotti from the World Health Organization (Geneva) provided technical support in planning the situational analysis and the guidelines development.
The guidelines were developed following extensive consultation with various local stakeholders which included patient representatives, non-governmental organisations involved in eye health, nurses, internal medicine physicians, allied eye health workers and ophthalmologists from OSM. It is anticipated that these guidelines will be a valuable resource in the control of blindness from diabetic retinopathy and glaucoma in Malawi.