A strong primary eye care system is fundamental to Universal Eye Health. The Vision Centre (VC) concept is a key driver towards accessible and affordable primary eye care in India and other parts of the world. Mission for Vision under its Mission Jyot initiative has established 71 VCs in partnership with leading eye care centres in 13 states of India, as of December 2021.1 VCs have been found to be uniquely effective and relevant particularly during the COVID-19 pandemic. Amid local lockdown protocols, communities residing in remote locations of the country had continuous source of eye care services through these VCs.
In order to ensure safe delivery of eye care, several adaptations had to be made to Mission For Vision’s VC strategy. These have been in alignment with government advice and local policies. This document articulates the various adaptations made to the VC approach for it to continue to provide primary eye care services in these geographies.
SPECIFIC MEASURES TAKEN TO ENABLE AND ENHANCE ACCESS TO PEC SERVICES
- Strict adherence to COVID-19 safety protocols
Ensuring adherence to COVID-19 safety protocols during the pandemic has had a positive impact on the number of clients served. The various COVID-19 safety protocols include (i) protection of VC personnel, (ii) safeguarding infrastructure and equipment, (iii) administrative and clinical protocols and (iv) patient safety protocols.2
Information on adherence to these COVID-19 safety protocols were publicised by putting up banners at each VC. In addition, tele-calling was used to educate patients on these protocols.
- Use of mobile health technology (mHealth)
Based on Management Information System maintained at the VCs, staff use mobile phones to enquire about patients’ health, update them about COVID-19 appropriate protocols at the VCs, counsel, comfort and gently encourage them to visit the VC for follow-up care. Several calls were needed in some cases. Appointments were scheduled at specific times of the day to avoid crowding and to promote the safety of the beneficiaries visiting the centre and its staff. This gradually encouraged increasing confidence among the community to visit the centres. For instance, the VCs run in partnership with Siliguri Greater Lions Eye Hospital served an average of 14 persons a day even during the harshest phase of the pandemic.
- Involving and communicating with community leaders and local officials
Regular communication with local government officials and opinion leaders was another strategy adopted by partner HV Desai Eye Hospital in parts of Maharashtra. This instilled confidence among the influential group, who in-turn helped dispel fears and myths among their community members and encouraged them to visit the VCs for care, resulting in two VCs witnessing an average of 30 patients monthly.
- Limited but targeted door-to-door screening
Partner CL Gupta Eye Institute (CLGEI) commenced home visits with local government permission in several villages in Uttar Pradesh. This activity was primarily done in the areas declared as “green zones” by local governments initially. Those over 40 years of age were screened and referred to the VC, as needed. Such visits gave an assurance to the community, who increasingly accessed services offered by the VCs run by this partner. CLGEI’s Dhanora and Dhampur VCs have steadily maintained about 12 patients a day due to this approach.
- Use of social media platforms
Patients were encouraged to connect with the VC staff on various social media platforms like WhatsApp, Facebook, etc. This has helped in sharing vital information with the patient pool and spread the word on VC operations, including the COVID-19 safety protocols. In many instances, online consultations were provided and later patients were followed-up with teleconsultations. VCs managed by Siliguri Greater Lions Eye Hospital and KB Haji Bachooali Charitable Ophthalmic and ENT Hospital have relied greatly on social media like WhatsApp as important tool to share information with patients to improve access.
- Organising mini-eye screening events on the VC premises
For the benefit of patients in the near vicinity of the VC, mini-eye screening events were organised with all COVID appropriate protocols at the VC premises. No user fees or registration fee was collected and this positively impacted the number of direct walk-in-patients who did not require any local transportation. Such mini-screening events were conducted on multiple occasions and as the word spread, more patients started visiting the VCs. CLGEI’s Dhampur VC has conducted many mini eye screening events to increase the footfall and focus on small retailers in the market.
These are some examples of effective strategies that helped continue primary eye care services in several remote parts of the country during the pandemic. They have contributed substantially towards reducing the backlog of citizens waiting for care in these regions during this period. The pandemic continues in its 22nd month in the country. In our opinion, these strategies would continue to be relevant even when we would have overcome the worst of the COVID-19 era.
- Mission for Vision. Mission Jyot. Mission for Vision, Mumbai. Available from: http://www.missionforvision.org.in/mission-jyot [Last accessed 12 January 2022].
- Mission for Vision. Adaptation Guidelines for Mission Jyot (Vision Centres). Mission for Vision, Mumbai. Available from: http://www.missionforvision.org.in/assets/web/assets/pdf/Adaptation_Guidelines_Mission_Jyot.pdf [Last accessed 12 January 2022].
Photo-credits to Mission for Vision.