Addressing Child Eye Health in SSA ICEE's Current Strategy

Addressing Child Eye Health in SSAICEE’s Current StrategyKesi NaidooSub-Regional Manager: Southern AfricaInternational Centre for Eye Care Education

The International Centre for EyecareEducationThe Organization• Founded in 1998 as a not-for-profit organization• Based in Durban, South Africa and Sydney, Australia• CEO: Prof Brien Holden• Global Programmes Director and Head of Africa office: Prof Kovin Naidoo• 106 employees (49 in Africa and 57 in Asia-Pacific)MissionICEE’s mission is to eliminate avoidable blindness and vision impairment caused by uncorrected refractiveerror by the year 2020Key elements• Education: Exponentially increase number of eye care workers, e.g. by setting up of optometry schools• Research: Eyecare research projects and M&E of programmes• Infrastructure / service delivery: Provision of facilities, equipment and spectacles• 20 Vision Centres and 200 eye units set up in Africa and Asia-Pacific• Global Resource Centre established in South Africa and China

Current Presence of ICEE

ICEE Strategy in Child Eye Health• Research– RESC– Improved database to enhanceadvocacy– Investigate effective service deliverysystems• Human Resource Development– Focus on primary and secondarylevel cadre’s– Optometry Schools– Material Development– Teachers Vision Screening– Primary Eye Care Nurses Screening

Existing services - Research• Refractive Error Study in Children in Africa (RESCA)– Population based survey of refractive error and visualimpairment in school aged children– Other studies: Nepal, Chile, China, India– ICEE:• Durban, South Africa (2001-2002)• Ghana (2010)– Develop refractive error data to guide refractive errorprogramme delivery specifically for children

RESCA: Durban – Key Results• 5599 children living in 2712 households wereenumerated, and 4890 (87.3%) were examined• Prevalence of VA 6/12 or worse in better eye– Uncorrected = 1.4%– Presenting = 1.2%– Best corrected = 0.32%• Exterior and anterior segment abnormalities in 10.8% ofchildren – indicative of poorly developed primary eyecare.

RESCA - contCause of Reduced Vision12%3.10%3.70%9.90%7.30%63.60%R.E.amblopiaRetinal DisordersCorneal opacityotherunexplained• Refractive error and visual impairment in African children in South Africa.• Naidoo KS, Raghunandan A, Mashige KP, Govender P, Holden BA, Pokharel GP, Ellwein LB.

Existing services: The KZN Child EyeCare Programme• Started in 2007• Screened 239 606 primary schoolchildren• 10 707 Optometric assessments• 1803 spectacles prescribed• Public – Private Partnership(PPP)• Primary and secondary level• Total Cost per 2 years $ 300 000

KZN Child Eyecare Programme -StructureWALTONSSTATIONERSICEEKZN DEPT OFHEALTHDISCOVERYFOUNDATIONKZN CHILDEYE CAREPROGRAMMEKZN DEPT OFEDUCATIONNISSANSOUTHAFRICAUS AID

No. Of ChildrenExaminedKZN Child Eyecare Programme Outputs• Advocacy benefit – breaklegislative log jamsOutputs per Sector• DoE/DoH/ICEEpartnership – task teamICEE• Enabled theinstitutionalisation ofRefractive Services forschool children• ReplicabilityNissan MobilePublic SectorCumulativeTotalTime

New services• Gauteng Child Eyecare Program– Based on KZN program– DoH/DoE/Nissan– Primary/Secondary levelintervention– Institutionalise school eyecare– 90 000 USD for 2011-2012• Vision Centres– Refractive error service, includingchildren– Tanzania, Zambia, Ghana

Future Plans• Population based surveys in SSA to increase availabledata on R.E.• Expand to other SA provinces – use KZN and Gautengexperience to develop a national program• Introduce Child eye care programs in countries in whichoptometry schools are developing the optometry cadre– Mozambique– Malawi– Uganda– Tanzania• Collaborate with partner organisations in research andHRD

THANK YOUKesi NaidooEmail: kesi@iceeafrica.co.za