Field perceptions of the Vision Initiative for Children\u27s preschool vision screening training model

Because lay vision screeners rarely receive formal training in how to screen vision and because older children were seen in clinic with vision disorders that should have been detected earlier through vision screening, a pediatric ophthalmologist and the researcher created the Vision Initiative for Children (VIC) in 2001 as a statewide program of the West Virginia University Eye Institute. VIC has trained, equipped, and provided ongoing support to lay individuals who are mandated or want to screen preschoolers\u27 vision. This program evaluation study explored, from the perspective of Head Start personnel, whether VIC prepares Head Start personnel to screen preschoolers\u27 vision and whether participants encountered screening experiences that were not discussed during VIC\u27s workshop. Forty-seven participants, representing 8 of the state\u27s 24 Head Start grantees, completed an evaluation at the end of each workshop; 27 completed a postworkshop evaluation after screening vision. The workshop evaluation captured perceptions of the instructional content and delivery system, the instructor\u27s skills in teaching and delivering the content, and the logistical arrangements. The postworkshop evaluation captured perceptions of the workshop after screening vision. This study also explored whether participants learned new vision screening knowledge, as measured by the difference between pretest and posttest scores administered at the workshop; whether they maintained knowledge, as measured by the difference in scores between the workshop posttest and a 3-month posttest; and which of VIC\u27s job aids they preferred. Results yielded positive perceptions and indicated that participants learned and maintained a significant amount of knowledge, regardless of education. Participants preferred a flowchart (96%) and handout packet (92%) over a web site (15%) as job aids for transferring learning from the workshop to the workplace. Results indicated that 44% of participants encountered no vision screening experiences that were not discussed during the workshop; 56% encountered distracting screening environments, uncooperative younger children, and concerns that pediatricians, in follow-up exams, reported vision was good although children failed vision screening. Additionally, 92% of participants reported that animated Microsoft PowerPoint slides enhanced their learning, 96% reported that receiving instructor feedback during practice enhanced their learning, 100% reported that practicing tests were necessary parts of a vision screening workshop, and 98% reported that an instructor\u27s modeling and demonstration of tests were necessary parts of a vision screening workshop

Visionary Spring 2011

https://nsuworks.nova.edu/hpd_opt_visionary/1006/thumbnail.jp

Reducing vision impairment in children through health system assessment and strengthening approach in Papua New Guinea.

Doctoral Degree. University of KwaZulu-Natal, Durban.ABSTRACT A strong and efficient integrated health system is able to contribute to the reduction of vision impairment among children by ensuring preventive measures are implemented and timely access to care is done in case of morbidity. Children in Papua New Guinea presenting late for congenital cataract surgery, incurring avoidable eye injuries, living with uncorrected refractive error and some presenting with advanced retinoblastoma were of concern to the researcher. The overall aim of the study was to assess how the current health system in Papua New Guinea is addressing child eye health using Port Moresby General Hospital and Goroka hospital as case studies. It is envisaged that a health strengthening approach benefits children’s eye health in the community. Methods Both quantitative and qualitative methods were employed. Retrospective medical records review of children seen at the eye clinic in Port Moresby and Goroka Hospitals from January 2015 to December 2017 was conducted. In the qualitative method service providers and caregivers were interviewed to obtain their perspectives regarding performance of the health system. Results At Port Moresby General Hospital trauma, conjunctivitis and corneal ulcers accounted for 21.6%, 18.9% and 9% respectively of all the diagnoses among children. Trauma was in the ratio of 1:1 (p= 0.264) male to female. And 7.3% (n=51) of the children were blind (according to the WHO definition). Among the blind children optic nerve disorders accounted for 20.5 %( n=14) followed by both un-operated cataracts and uncorrected refractive error each at 13.2% (n=9). Retinoblastoma presented at mean age 5.869 (SD4.5) and 6.02(SD 2.4) years for girls and boys respectively. The main causes of ocular morbidity observed at Goroka Hospital were corneal ulcers (24.9%), uveitis (9.3%) and foreign bodies (9.2%). Service provider interviews revealed lack of policy on child eye health, shortage of health personnel and limited community eye health services. But among care givers lack of eye health information in the community, concerns about long waiting time at the hospitals and inadequate explanation about conditions affecting the children featured prominently. Conclusion Findings show a higher percentage of blind children compared to similar hospital based studies elsewhere. To achieve universal eye health coverage, raising awareness about child eye health needs among leaders in health is urgent. Successes registered in the past in Papua New Guinea in other child health efforts like immunisation suggest that a consistent and focused health system strengthening approach with greater integration may contribute to reduction of vision impairment among children. A proposed child eye health strategy based on the findings from this study is included in this thesis

Comparison of effectiveness of using trained key informants versus health surveillance assistants in identifying blind and visually impaired children in Malawi.

Eye conditions associated with visual impairment and blindness in children, such as congenital cataract, can lead to long lasting visual problems if treatment is delayed. There is need to determine which method can be more effective in identifying blind and visual impaired children. In this study, two methods of identifying blind and visual impaired children (using key informants versus using health surveillance assistants) were compared in a randomised community study conducted in three districts in Southern Malawi. The ministry of Health was advocating for the training of Health Surveillance Assistants (HSAs) in primary eye care, which included case detection and refer of blind and visually impaired children; and the alternative was the training of key informants (KIs). The study was done to compare the effectiveness of the two methods of case identification and to provide guidelines on optimal approaches of identifying blind and severely visually impaired children in Malawi. Twelve clusters (group of villages) were selected, and six were randomly assigned to each group. After training in case identification and referral, Key informants and Heath surveillance assistant identified children from the clusters, within a six-week period, and the number of blind and visual impaired children identified in each group was determined and compared. In total, 159 Key informants and 151 Health Surveillance Assistants were selected and trained, and they identified 550 children with eye problems, among whom, after examination, only 15.1 % were blind or severely visually impaired. Key informants identified one and half times more blind/severally visual impaired children than HSAs (37 vs 22).The prevalence estimates of blindness among children identified by KIs was 3.3 per 10,000 (95% CI 2.7-3.9), while the prevalence estimates of blindness among children identified by HSAs was 1.9 per 10,000 (95% CI 1.3-2.5).The difference was statistically significant (P=0.03), but overall the number of children identified by both groups was lower than was the expected from prevalence estimates of 8.0 per 10,000. False positives between HSAs and KIs were comparable, with 68.8% of children identified by HSAs as blind, confirmed blind on examination, in comparison to 72.5% of children identified by KIs, also confirmed as blind on examination. Cortical blindness seconded by cataract were the commonest causes of blindness. In conclusion, Keys informants were more effective than Health Surveillance assistants in identifying blind and visually impaired children in Malawi, and this study supports and confirms findings from other areas

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