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Taking a Systems Approach to Eye Health

Published: 14.07.2015

Re-posted with permission from the IAPB Western Pacific blog.

EHSa Workshop participants, Hanoi, Vietnam IAPB Western Pacific, 2015
In early July, eye health experts from across Asia and the Pacific gathered in Hanoi for a 5-day short course to workshop ways to strengthen health systems, improve eye health and work towards Universal Health Coverage.
Held at Hanoi School of Public Health, the course was delivered by Dr Karl Blanchet from the London School of Hygiene and Tropical Medicine, with funding from Australian Aid. Lectures on principles of health financing, the situation in Vietnam, governance and leadership, human resources, integration, quality and service delivery expanded knowledge on the key issues facing eye health programs.
Traditionally, some eye health programs were developed to run parallel to broader health systems. In more recent years, programming for blindness prevention has become more intergrated and horizontal, and WHO’s Universal Eye Health: A Global Action Plan 2014-19 has a clear emphasis on health systems strengthening. Of course there is still much more to do, particularly to ensure services are sustainable and high quality.
How can we make maximise the benefits from social insurance programs to increase services for the poor? How do we train more eye doctors and nurses, and make sure we don’t strain or reduce the capacity of other parts of the health system? What impact do referrals have on efficiency? How can hospitals be managed more efficiently? What does integration really mean? It was these questions, and many others, that kept participants busy over the week.
The course content centered on WHO’s six building blocks of the health system and gave participants an opportunity to look at the Eye Health Systems Assessment (EHSA) tool. Working in small groups, participants used the tool to examine strengths and weaknesses of eye health systems in Myanmar, and design projects to strengthen systems and improve eye health.
One of the course participants, Saeng Peou from the Fred Hollows Foundation in Cambodia, identified the material on governance and health economics as most interesting. “This reminded us that resources are scarce and that we should use them effectively when we develop a project. The tool for defining the six building blocks will help guide us and help us to think more comprehensively in an assessment of health system,” Peou said.
Thao, a participant, receiving a certificate from Karl Blanchett on completion of the courseThe short course brought together broad experience from across the region with participants from Vietnam, Australia, Nepal, Cambodia, Indonesia, Papua New Guinea, Lao PDR, China, Philippines, Sri Lanka, India and the Maldives. Participants came from a mix of professional backgrounds: eye doctors, health ministry officials, program coordinators and NGO staff.
“The course enlightened me with an in-depth understanding of the WHO framework that describes health systems in terms of six building blocks to consider when moving towards universal coverage,” said Sailesh Kumar Mishra from Nepal Netra Jyoti Sangh, Nepal’s national society for comprehensive eye eare. “I learned a lot from the high-quality lectures, as well as from the group work.”