What is integrated people-centred eye care?

Delivering effective eye care services

According the World Report on Vision, eye health services are often fragmented, uncoordinated, unregulated, and of variable quality. There are also shortages and maldistribution of eye health services, and where services exist, they may be poorly integrated.

However, integrated people-centred eye care (IPEC) has the potential to address many of these challenges to delivering effective eye care services.

As summarised in the World Report on Vision, integrated people-centred eye care:

is defined as services that are managed and delivered so that people receive a continuum of health interventions covering promotion, prevention, treatment and rehabilitation
should address the full spectrum of eye conditions according to their needs, coordinated across the different levels and sites of care within and beyond the health sector.
recognizes people as participants and beneficiaries of these services, throughout their life course.

How can integrated people-centred eye care be implemented?

The implementation of integrated people-centred eye care requires four strategies:

Empowering and engaging people and communities.
Reorienting the model of care;
Coordinating services within and across sectors; and
Creating an enabling environment.

Empowering and engaging people and communities

We can empower and engage communities in eye care through increased awareness of the:

importance of regular eye examinations
availability of services
use of medication.

This can be achieved through various methods including the use of education and technology.

Reorienting the model of care

To address population eye care needs, all levels of eye care are needed, from community through to specialised tertiary care. These must include integrated and effective referral pathways.

We need to use innovative models of care to strengthen eye care in universal health coverage and ensure:

adequate funding
appropriate training for a sustainable workforce
coordination with other services and sectors, and
effectively planned referral systems.

Coordinating services within and across sectors

The World Report on Vision reminds us that without good continuity and coordination of eye care, patients are at risk of experiencing fragmented, poorly-integrated care from multiple providers.

Coordination of care for the individual involves a range of strategies including case management, team-based care, and efficient referral systems.

Coordination also encompasses the creation of linkages between eye care and other health programmes.

Creating an enabling environment

WHO has conceptualized an enabling environment as six building blocks of a health system. The following three blocks include specific challenges faced by the eye care sector.

Leadership and governance

The responsibilities of governance in health care involves developing a strategic plan, then managing accountability and overseeing the plan’s implementation.

Health workforce

IPEC depends on the availability, accessibility, acceptability and quality of services provided by the health workforce.

Information

A well-functioning health information system should collect information about the capacity of the health system to provide eye care services. It should also measure its performance – how well existing eye services address population needs in an equitable manner.

Summary

The concept of integrated, people-centred eye care, as promoted in the World Report on Vision, confirms that by working hand-in-hand with Ministries of Health, we can ensure eye health services reach those who need services the most. In this way, we can make a huge difference in the lives of people for generations to come.

Reference: World Report on Vision, World Health Organization, 2019.