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Dr Irmela Erdmann, Dr Manfred Moerchen and Dr Demissie Tadesse, members of the CBM team share their thoughts and learning from their involvement in different sessions at the IAPB Council of Members.
After many months of preparation, CBM and Sightsavers finally met for the interactive workshop “Leaving no one behind: strengthening inclusion and equity in eye health”. We gathered a very diverse group of some of the main stakeholders involved in eye health programmes around the world and people with different types of disabilities from Disables People’s Organisations in Tanzania.
Evidence suggests that people with disabilities face numerous barriers when accessing health services and are more likely to have poor health. Lupi Mwaisaka from the Tanzania Society for the Deaf for example pointed out that people with hearing impairment often do not understand instructions on how to take medication or apply eye drops. This can have serious consequences, simply because health staff are not trained to communicate with people with hearing impairment. It became obvious that greater effort is needed to enable eye hospitals to meet the needs of all their patients, including those with hearing, physical and learning impairments.
Colleagues from Light for the World and Sightsavers introduced participatory tools designed for improving accessible services in hospitals. CBM highlighted the need to intensify efforts to integrate inclusion in the training curricula of medical schools. The workshop concluded with a focus on disability data from various low-and-middle income countries. It was encouraging to see significant improvements in the availability of disability data. For instance, data from a CBM supported project in Paraguay suggested that, surprisingly, almost 10% of all patients at an eye hospital reported severe communication difficulties. This is a strong indication that specific steps need to be taken to address these communication barriers.
This well-attended session looked at how to achieve universal eye health which is comprehensive, inclusive, of high quality, accessible and sustainable. One major challenge as well as an opportunity for achieving this in the African context, is the role of national health insurance systems. CBM provided some practical examples of our eye care partners in Rwanda and Tanzania who already benefit from the health insurance system. Health insurance coverage in Rwanda has reached over 90% of the population. This has encouraged more people to look for services and go for surgeries, including patients who used to struggle to pay for surgeries. As a result of this, health centres no longer have to worry about subsidising their costs. On the contrary, the centres are generating a major part of their service revenue through the insurance system, improving the sustainability of partners and decreasing dependency on donors.
Another example from a CBM partner organisation – integrated diabetic care – was used to demonstrate how the many good and practical guidelines for integrated diabetic care that are available, can be implemented to achieve clinical excellence.
Dr Abdulaziz from King Khaled Eye Specialist Hospital in Riyadh then focused on quality of care as a result of training, standards and audits. He emphasised that universal coverage should never compromise quality and should not come at the expense of addressing more challenging and emerging eye conditions like diabetic retinopathy.
CBM’s Tanzania office hosted the working group “Climate Action” of the IAPB climate action working group. It is well known that “in terms of eye health, communities that are most susceptible to environmental degradation tend to carry some of the highest rates of avoidable and permanent blindness.” During the workshop, the group discussed how to further strengthen Environmental Sustainability Programmes (advocacy, policy, training, research) and continued to prepare sessions for the IAPB Global Assembly 2020 in Singapore, where Sustainability will be one of the three main conference themes.