Global Blindness OER : Planning and Managing Eye Care Services

Around the world, 285 million people are blind or visually impaired. 75% of this is avoidable and 90% is in low- and middle-income countries. Learn the key facts about avoidable blindness, the global initiatives to address it and explore practical, tried and tested approaches for strengthening local eye health services, in resource limited settings.

 

Materials from the course are published under a Creative Commons license (CC BY-NC-SA-4.0) which permits non-commercial re-use without asking for permission. We encourage you to download, adapt and share these Open Educational Resources (OER) for teaching and learning.

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Week 1: The burden of avoidable blindness

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Week 2: VISION 2020 and Universal Eye Health

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Week 3: Cataract control strategies

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Week 4: Refractive error control strategies

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Week 5: How to plan

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Week 6: Implementing and monitoring the plan

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Download individual resources

Week 1 : The burden of avoidable blindness

Video: Welcome to the course and week 1

Dr Daksha Patel, lead educator, introduces the course and the topics explored in week 1

Video & teaching slides:  An introduction to epidemiology

In this step, we consider the definition of epidemiology more thoroughly and discover some commonly used epidemiological terminology.

Video & teaching slides:  Defining visual impairment

In order to understand the epidemiology of visual impairment we need to use an agreed definition of visual acuity. In this step we look at the World Health Organization’s (WHO) classification of visual impairment, which will be used throughout the course.

Video & teaching slides:  Epidemiology and visual impairment

In this step we introduce the epidemiology of blindness and visual impairment, looking at four key concepts: Magnitude; Distribution; Determinants and Control.

Video : The Gambia eye care programme

Professor Allen Foster describes the steps that Dr Hannah Faal, an ophthalmologist from the Gambia, took to develop and implement this plan and explains why it became a model for the global VISION 2020 programme to end avoidable blindness.

 

Week 2. VISION 2020 and Universal Eye Health

Think globally and act locally

Discover the ideas behind and achievements of the global initiative VISION 2020: The Right to Sight, which aims to end avoidable blindness by the year 2020.

Understand the plans to scale up global eye care through Universal Eye Health, and consider how this is applied in local settings through the eye health systems approach.

Video: Welcome to week 2

Dr Daksha Patel, lead educator, introduces the course and the topics explored in week 2

Video & teaching slides: VISION 2020: The Right to Sight

In this step we look at how programmes have been implemented in order to address the growing burden of visual impairment and introduce VISION 2020: The Right to Sight, the global initiative to end avoidable blindness.

 

Article:  VISION 2020: how are we doing?

In this article we assess the achievements of the VISION 2020: The Right to Sight initiative so far, and taking stock of what still needs to be done.

Video & teaching slides: Action for the next decade in eye care

In this step we look at the plans to scale up global eye care in the next decade through Universal Eye Health and the eye health systems approach.

Video: IAPB and the Global Action Plan

Peter Ackland, CEO of the International Agency for the Prevention of Blindness, discusses the work of the organisation as it leads attempts to eliminate avoidable blindness.

Article:  Introducing the Zrenya case study

In this step we introduce the Zrenya hypothetical case study, focusing on a fictional location that shares many of the common challenges faced by low and middle income countries.

Week 3. Cataract control strategies

Managing the quantity, quality and cost of cataract surgery

How can we deliver the high-volume, high quality, and efficient cataract services needed? What is the role of innovation in eye care, and what opportunities can it offer?

Video: Welcome to week 3: cataract control strategies

Dr Daksha Patel, lead educator, introduces the course and the topics explored in week 3

Video & teaching slides: Understanding cataract output

In this step we look at the public health strategies used to prevent and control cataract blindness.

Video & teaching slides: Managing barriers

In this step we look at the reasons why and how we can better manage the barriers, including patients not coming for surgery and ineffective or inefficient eye care units.

Article: Peek: innovation to bridge the gap between providers and patients

Can mobile technology help us bridge the gap and deliver eye care to poor and remote settings?

Video: Challenges of delivering cataract services in Nigeria

Professor Caleb Mypet discusses how to create demand and deliver high output and high quality cataract services in challenging circumstances.

Video & teaching slides: Managing cataract outcome

In this step we look at the reasons why and how we can better manage the barriers, including patients not coming for surgery and ineffective or inefficient eye care units.

Video & teaching slides: Managing the cost of cataract services

In this step we look at the reasons t how to manage the cost of cataract outlay.

Video: Efficient high-volume cataract services: the Aravind model

Dr Thulasiraj Ravilla, Executive Director of Lions Aravind Eye Institute of Community Ophthalmology introduces the Aravind Eye Care System approach to providing large volume, high quality, and affordable services in a financially sustainable, equitable manner.

 

Week 4. Refractive error control strategies

What are the factors which affect refractive error service delivery? Why is school vision testing an effective way of addressing this burden? How can we make refractive error services sustainable in low- and middle-income settings?

Video: Welcome to week 4

Dr Daksha Patel, lead educator, introduces the course and the topics explored in week 4

Video & teaching slides Understanding refractive error

In this step we define refractive error in the context of public health and describe its epidemiology.

Article: Vision testing for refractive errors in schools

In this step we discuss how to use vision testing to detect uncorrected refractive error in developing countries

 Video & teaching slides: Developments in school vision testing

In this step we define refractive error in the context of public health and describe its epidemiology.

Video: Refractive error and school health in India

Dr G.V.S. Murthy, Director of the Public Health Foundation of India, gives a brief overview of the development, successes, and challenges of India’s ambitious national programme for school vision testing.

Video & teaching slides: Managing presbyopia

In this step we define refractive error in the context of public health and describe its epidemiology.

Article: How to prescribe spectacles for presbyopia

This step considers how to prescribe spectacles for blurred near vision, or presbyopia.

Video: An overview of refractive errors in Africa.

In this step we show how schools in Kenya are using Peek mobile technology to screen and refer children with vision problems to the local eye unit for examination and treatment.

Week 5. How to plan

When planning for change we need to know where we are now. What tools and methods can help us figure this out? Once we know where we are and have identified gaps in the current provision, we can choose our direction and focus for change.

Video: Welcome to week 5

Dr Daksha Patel, lead educator, introduces the course and the topics explored in week 5

Video & teaching slides: Principles of planning

In this step we discuss why change in health care does need to be planned and introduce the basic principles behind planning for eye care programmes.

Video & teaching slides: Situation analysis

Situation analysis is a collection of methods that helps planners and managers understand an organisation’s performance and internal and external factors affecting it.

Article: Differences between national and district planning

This step looks at the distinction between local and national planning.

Article: The application of planning

In this step we interview Edson Eliah, Deputy Director of the Kilimanjaro Centre for Community Opthalmology (KCCO)

Article: Principles of district planning

This step explores the approach and depth required for a situation analysis, suggest the types and sources of information required, and how this stage provides the platform for identifying levels and direction of change.

Infographic: SWOT analysis of an eye unit

Video & teaching slides: Aims and objectives

In this step we look at the concept of aims and objectives, the purpose of SMART objectives, and the links between activities, objectives, and targets..

Article: How do we define aims and objectives?

This step explores the approach and depth required for a situation analysis, suggest the types and sources of information required, and how this stage provides the platform for identifying levels and direction of change.

Article: Setting targets

This step we look at the type and sources of information that may be necessary to set targets for the planning of cataract or refractive error services at the district level.

Week 6: Implementing and monitoring the plan

What are the practical steps planners need to take as a plan is put into action? How can planners check that a plan is progressing, and how do we know if it has made a difference? Explore some basic monitoring and evaluation tools you might use to improve cataract and refractive error services in a local setting.

Video: Welcome to week 6

Dr Daksha Patel, lead educator, introduces the course and the topics explored in week 6

Video & teaching slides: Priorities, timetables and budgets

In this step we will consider how to set priorities and introduce the links between objectives and activities.

Article: Key tips for developing an implementation strategy

In this step we look to identify the key steps in establishing a strategy for the plan.

Article: Budgeting for a district VISION 2020 programme

In this step we look how to budget for a district VISION 2020 programme and consider the most important resources to be managed: people’s time, and money.

Article: Activity time planning

This step shows how to manage the most important resources in an activity: people, their time, and money.

Video & teaching slides: Principles of monitoring

In this step we introduce the principles of monitoring in the programme planning cycle and explain the different kinds of indicator planners use to check how a plan is progressing.

Article: Monitoring progress

In this step we look at the reasons why we monitor and evaluate district plans.

Video & teaching slides: Programme evaluation

In this step we look at why you should plan for evaluation activities at the beginning of the planning cycle

Article: Eye care planning at the district level: case studies from Asia and Africa

Video & teaching slides: Keep it simple!

In this step Professor Allen Foster, co-director of the International Centre for Eye Health at the London School of Hygiene & Tropical Medicine, talks about his personal experiences of the impact of planning for the prevention of blindness.

Article: Concluding reflection

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