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Global activity to end avoidable blindness – Are we having an impact?

Published: 22.05.2015

IAPB Joins the Fred Hollows Foundation in soliciting responses for the ideas listed in this blog post – especially around creating a Working Group for IAPB members. If you are interested, or have anything to share, please write to [email protected]

In December 2013, The Fred Hollows Foundation launched its 2014-2018 Strategic Plan; which outlines what we will achieve in the next five years to realise our vision of a world in which no person is needlessly blind and Indigenous Australians exercise their right to good health.

As CEO, I have been very conscious of the need to make sure that our Strategic Plan does not just sit on the shelf, but is a document that is actively used to help us make important decisions about where we need to focus our efforts, activities and investments. Over the past two years, we have also invested heavily in improving the metrics by which we measure and report on our performance and progress.

As part of this work, The Foundation’s Board recently endorsed a series of ‘long term outcome indicators.’ These indicators aim to provide more clarity on the outcomes we are seeking to achieve through our Strategic Plan. We’ve been setting targets for our work and measuring ourselves against those for a long time, but recognised that statements in our Plan like ‘cataract is effectively managed’ could mean many things to many people. By articulating a clear set of outcome indicators, we can provide all our staff and partners with greater clarity about what The Foundation is seeking to prioritise for effective cataract management (and each of our strategic objectives).

This reflects an important shift in focus from measuring performance (in terms of activity and outputs) at project level, or in the specific provinces in which we work—to one that seeks to measure and evaluate our impact. Of course, we will continue to gather and report on data at project level, but by also measuring progress towards our long term outcome indicators we can ensure that The Foundation remains true to its ultimate vision and purpose over the period until 2018 and beyond.

China, Image: The Fred Hollows Foundation

In developing these indicators, The Foundation has attempted to build on the outstanding achievement of the Global Action Plan for Universal Eye Health (2014-2019); which, for the first time, establishes three indicators (the prevalence and causes of visual impairment; the number of eye care personnel; and cataract surgery) by which all Member States will measure and report their progress towards our common goal.

In a number of cases, we will clearly need to rely on the data gathered and reported by Member States to track progress towards our long-term outcome indicators. In others, data and information gathered by The Foundation, in combination with data collected by other NGOs has the potential to add to the information provided by Member States and provide a more comprehensive overview of global progress towards the goals and vision of the Global Action Plan.

A total of 26 Indicators have been developed across the five strategic objectives in our Plan. Two types of indicators have been developed:

  • lag Indicators—the long-term outcomes and impact we desire; and
  • lead indicators—outputs that can be measured each year and that allow us to track whether we’re on target to achieve our long-term objectives.

Over the coming months, definitions and specific targets will be developed for each of the indicators to ensure measurement is consistent across the organisation.

In developing these indicators, The Foundation is conscious that we are only one of many players on the global stage seeking to address the issue of ending avoidable blindness.

We are keen to understand how other organisations are tackling the same issue of measuring progress against their aspirational outcomes. We also consider there would be merit in eye health NGOs working collaboratively together to develop some long-term outcome indicators that could be reported on globally—or as a minimum, sharing data and data sets; and information about methods of data capture and reporting. The Fred Hollows Foundation would welcome an IAPB-led working group facilitating this type of discussion.

Greater international collaboration in this area would not only allow us to undertake some global analysis of progress towards the shared outcomes we are seeking but would strengthen the impact of reporting on individual efforts; allow us to learn from each other and sharpen our focus and efforts. Improving our capacity to measure and report on our impact may also improve our collective efforts to mobilise funding from a variety of different sources into activities that will contribute to our ultimate goal of ending avoidable blindness.

The Fred Hollows Foundation Long-term Outcome Indicators
Lag Measure & Indicator Lead Measure & Indicator
Cataract is effectively managed
Prevalence of cataract  blindness and visual impairment Cataract Surgical Rate
Cataract Surgical Coverage
Cataract Surgical Coverage (ratio female to male)
Quality: % of surgeries meeting post-surgical visual acuity standards.
Trachoma is eliminated
Trachoma is eliminated TT surgeries completed
MDA coverage
Effective in-country WASH partnership
F&E take-up
Eye health services are available throughout the world for people living with diabetes
% of people with DR Government adopts standard of care to manage eyes within diabetes management
% people with diabetes with first screening for DR
% people with confirmed diagnosis for DR with annual follow-up
Effective in-country diabetes partnerships
Effective partnerships with IDF and WDF
Eye health services and systems are sustainable and integrated into national health systems
Eye health is embedded in the national health strategy Implementation by governments of Global Action Plan commitments
Demonstrable scalable approaches to effective eye care
Country teams engage with networks, consortia or partners outside eye health
Global teams engage with networks, consortia or partners outside eye health
Eye health services are available as part of school health programs
Eye health is appropriately resourced
Ophthalmologists per million population % increase in Public / national insurance spending on eye health
Optometrists per million population  
Allied ophthalmic personnel per million population