General updates from Phase 5 projects

General updates

Addenbrookes Abroad Botswana

For World Sight Day 2013, the project tried an innovative approach to raise awareness of World Sight Day, the Universal Eye Health message and of our project. The Zebra is the national emblem of Botswana – it appears on the national flag and is the name of the national football team. We sourced a concrete life sized Zebra which was placed outside the Ministry of Health for the week of World Sight Day. We called the Zebra ‘Pono’ which means sight in Setswana and the zebra statue was either blindfolded or wearing large glasses throughout the week. Members of the Media, Standard Chartered Bank and Ministry of Health staff were invited to the unveiling of the Zebra.

Leaflets calling individuals to have their eyes tested were distributed throughout the week. A Ministry of Health colleague from the Health Promotion department dressed up in a zebra suit to distribute leaflets. We named him ‘Letlotlo’ meaning ‘to be treasured’ in Setswana, and the second half of the name of our project. There was good coverage in the Press and in the Ministry of Health internal magazines of Pono the Zebra – a different approach to awareness raising which we plan to build on in subsequent years.

Evelyn Brealey

CBM Philippines – Monitoring & Evaluation/Networking

Evaluating the capacity building activities can only be known a month or so after. It is quite difficult for us to monitor all the trained people individually so what we do is to contact the point person and get updates. We found this effective as the organizing group who requested us for the training has the clout to follow-up on them and this in turn is giving the partner the shared role and responsibility. In the process, it strengthened the partnership and widened the networking as we connect the organizers to our partners for referrals so they can communicate directly to each other. This has eased us from the burdens of too many points of communication. Things are done with regular update to us so that everyone is kept in the loop.

Laura Gore

FHF Vietnam

Lam Dong and Dak Nong are located in the mountainous areas. They cope with the severe shortage of human resources and facilities and are not yet familiar with eye care projects. Helping new project implementers to be able to manage the project effectively is very necessary.

Firstly, an orientation workshop is the most important work that happened in early 2013. This activity will help the implementers understand fully requirement and policies of donors, including project finance management and reporting. In this workshop, former implementers of other projects are invited to share experience in project implementation and management.

Secondly, hands-on coaching on planning and implementing project frequently took place between the implementers and FHF staffs. It takes approximately 6 months for the implementers to get acquainted to the work. Thus, managers should have patience and sympathy with the new implementers.

Thirdly, on-going monitoring should be done frequently to keep project activities to be done in time with quality. Moreover, this task also helps implementers discover things need to be improved. To have good outputs in new project provinces, project activities should be allocated properly in number and timeframe.

With these steps, the project implementers will easily manage and minimise unexpected issues in project implementation.

Darren Williamson

OEU Ghana

The Ghana team under SIB V and relevant stakeholders having learnt from the implementation of phase IV of SIB, have decided to do on site training regarding the Ophthalmic Nurses training instead of bringing all of them together for such training. This is to afford the nurses the opportunity to have more hands on training specifically with regards to the slit lamp and the Perkin’s Hand Held Applanation Tonometer. Our monitoring and discussions with the nurses indicate they still lack in these areas and having them practice at their clinics under the supervision of specialists where there are enough patients rather than a workshop scene will inure to their benefit.

Emmanuel Kwasi Kumah

Orbis China CHEER

We are excited to share two of the programmatic implementation successes of the last six months. The project commenced to advocate multiple governmental sectors to involve in this project before the official opening by lobbying Provincial Bureau of Health (PBOH), Provincial Bureau of Education (PBOE) and PDPF to participate in the project design and co-issue a joint Red-head/official document at provincial level. We constantly consult these sectors at provincial level during the project implementation and also invited them to attend important events/meetings such as the official launch ceremonies at provincial and prefecture levels and the advocacy workshop.

Key achievements of the advocacy meeting were a platform established for forming a children’s eye health network in project areas; created an opportunity for participants from different sectors to know each other and to discuss children’s eye health issues together hence established primary relationship; agreed on the communication channel and the key coordinator in each counties or prefectures. We were happy to see their improved interest and attention on children’s eye health. They enjoyed the discussion and contributed a lot during the workshop.

Moreover, by introducing partners to and coordinating with the Taiyuan School for the Blind, the consortium is making positive progress toward achieving project objectives. Since the first meeting, partners have worked closely together with the school. The school has been very accommodating by assisting partners in:

·  interpreting education-related language and jargon with the assistance of its English teacher;

·  coordinating, organizing and enabling Perkins International to hold its first training on campus;

·  permitting eye doctors to conduct functional vision assessments on students; and

·  allowing SPEH medical staff to distribute a survey to its students.

The Taiyuan School for the Blind can become a place where infants, children, and young adults who are blind or visually impaired with multiple disabilities can receive support and services that they need. This project has taken the first step toward supporting and encouraging the school to become that kind of place. With support from this project, a sustainable program will be developed to serve children with visual and/or multiple disabilities.

Xu Yang

SS Uganda (from CBM CEH East Africa)

Overview of SiB Phase V Programme in Uganda

The Uganda SiB Child Eye Health (ChEH) Project is part of the regional child eye health programme being implemented in three East African countries: Uganda, Kenya and Tanzania for the period January 2013 to December 2016. The total planned investment for the regional project is US$6.25 million of which Standard Chartered Bank (SCB) will contribute US$ 5 million while implementing partner organisations will match this with US$1.25 million. Of these, the investment in the Uganda programme for the CBM lead consortia will be US$1, 178, 443 with the bank contributing US$ 942,755 and other funders contributing US$ 235,688

The regional project is being implemented by 12 organisations led by two consortia; one led by CBM and the other by Brien Holden Vision Institute (BHVI). To promote regional and support the the two consortia, regional and country coordination structures have been put in place. The members of the CBM led consortium include: CBM, Sightsavers, the Fred Hollows Foundation (FHF) and the College of Ophthalmology of East, Central and Southern Africa (COECSA). Each of the three programme countries has a country Lead NGO to coordinate activities of partners implementing the programme in the country. Sightsavers is the Lead NGO for Uganda.

The overall goal of the project is to improve child eye health and reduce the prevalence of avoidable blindness in children. The Uganda component will, among other outputs, enhance access to child eye services for 300,000; support surgical operations for 1500 children; and assist 4,500 children with refractive errors to access spectacles. To achieve this, the project adopts a health system strengthening approach. This entails strengthening and expanding the capacity of the three existing tertiary ChEH centres in the country: Mulago National Hospital for the central region, Ruharo Eye Centre for the western region and Benedictine Eye Hospital for the eastern region. A new tertiary centre will be established in Gulu Regional Hospital to serve the post-conflict region of northern Uganda. The establishment of a tertiary ChEH centre in Gulu Regional Hospital is in line with the plan of the Ministry of Health (MOH) to develop Gulu Regional Hospital into a National Hospital and will, in particular, be an important contribution to health services in the country. To further increase access to ChEH services, the project will establish secondary child eye health centres in Jinja, Soroti, Lira, Arua, Fort Portal and Mbarara regional hospitals.

An important aspect of establishing these tertiary and secondary ChEH centres is the training and deployment of paediatric ophthalmic teams and paediatric oriented ophthalmic teams in tertiary and secondary child eye health centres respectively. This involves training and upgrading the skills of the following health worker cadres: paediatric ophthalmologists, paediatric oriented ophthalmologists, paediatric theatre nurses, paediatric anaesthetists, orthoptists and low vision therapists. In addition, the project is developing systems for the identification and referral of children who need eye surgery from the community and primary levels to tertiary and secondary ChEH centres. This is being achieved by integrating child eye health into primary health care and community health activities. Specifically, the project is training and working with primary health care workers, reproductive health workers and community health workers to identify and refer children who need eye surgery. This is meant to strengthen the referral system from primary to tertiary and for older children from primary to secondary levels.

The other important component that the project seeks to strengthen in order to promote child eye health is leadership and the management information system. To structure this component, the country has been divided into four ChEH clusters with the leadership of each cluster being provided by the tertiary ChEH centre of that cluster while national leadership is integrated within the National Prevention of Blindness Committee (NPBC) leadership. Activities supported to strengthen leadership for ChEH at cluster and national levels include training in Vision 2020 planning and management and in targeted leadership and management skills. In addition, tertiary ChEH centres are facilitated to provide support supervision and help build capacity of the secondary ChEH centres. To ensure that data on ChEH is captured, analysed and utilized for decision making, programme development and policy influencing, the project is engaging with the planning unit of the Ministry of Health (MOH).

Last but not least, the project is promoting approaches and linkages with primary health care, child health and general development programmes and agencies that address interventions that promote child health in general. This includes participation in child development networks and initiatives such as Child Days and linking with child development agencies such as World Vision, Save the Children Fund and UNICEF.

It is noteworthy to highlight that Sightsavers Uganda country office has forged a close working relationship with the local standard chartered bank, an attribute which is not only promoting the SCB brand but is helping raise the profile of Sightsavers in the country. This has, in part, been enabled by the enthusiasm of the staff of the Corporate Affairs department of Standard Chartered Bank Uganda.

Amy Clark

Sightsavers Sierra Leone

“Clinicians Becoming Programme Managers” – the Sierra Leone experience

One of the challenges experienced since the inception of the project, is where Cataract Surgeons are expected to strike a balance between patient care and responding to other administrative and project commitments such as attending meetings, responding to E-mails, verifying output statistics and writing (narrative) reports.

Reporting, presenting project updates at meetings and monitoring the implementation of programmes has further strengthened their confidence in the development and implementation of eye health projects across the country. Usually, as clinicians, they wouldn’t want to leave patients waiting whilst responding to e-mails or writing reports.

Continued mentoring, coaching, hands-on support and review meetings will let partners see project implementation as ‘parts to a whole’ that is not only limited to clinical work. This will enhance the integration process as evidenced by the number of health projects developed by partners and how well they are managed.

Amy Clark