One Student One Family and the Mozambique Eyecare Project, the Interaction Between Optometry Students and the Community in Nampula, Mozambique

This paper aims to explore the successes and challenges of the One Student One Family Programme within the context of the Mozambique Eyecare Project

Framing Professional Programs Within Development Projects: Driving Longer Term Recognition and Integration

Background: Optometry has, over the past ten years, emerged as a profession strategically positioned to address the burden of uncorrected refractive error in developing countries. Estimates suggest that 285 million people in the world are needlessly visually impaired, mainly due to the lack of trained eye health professionals in the developing world. Development initiatives in eye care have therefore moved away from vertical, service delivery approaches to supporting the establishment of more sustainable, locally owned training programs. This research is based on one the evaluation of one such initiative known as the Mozambique Eyecare Project. Methods: This study followed a qualitative research design. Ethical approval was granted by the Research Ethics Committee at the Technological University Dublin, which followed the tenets of the Declaration of Helsinki. A qualitative, interview-based study was undertaken between 2012 and 2014 with eighteen key informants involved in the design, planning and implementation of the project. A semi-structured interview guide was developed to explore, inter alia, challenges relating to the establishment of the new profession of optometry in Mozambique. Data was coded and analysed thematically and results derived from a process of descriptive-interpretive analysis. Results: The establishment of a new profession within the ambit of a development project presents several challenges, principally the establishment of the profession\u27s identity in relation to similar professional cadres\u27 in-country. The risk of not addressing professional regulatory requirements for new programs, where equal or similar qualifications have not previously existed, are that the profession may not be officially recognised by the relevant health authorities and therefore not mainstreamed into public health services, or that training standards and scope of practice may be inappropriate to local needs. Overall, the public may become vulnerable to unscrupulous health care practices. Conclusions: Health professions are regulated in order to ensure patient safety, as well as minimum standards of care and training within professions. Development projects must address issues of professional identity and official recognition of health professions and their respective qualifications through relevant local authorities, so that graduate qualifications are legitimised and the longer term objectives of the development investment are supported

Design of a blindness prevention reporting and planning tool utilising the result of a population-based study of visual impairment in a health district in Kwazulu-natural

Introduction: VISION 2020, The Right to Sight program of WHO and the International Agency for Prevention of Blindness has focussed attention on the elimination of avoidable blindness and impaired vision through a bener understanding of the distribution of ocular conditions and diseases, the development and distribution of human resources and their relevance in planning of programs especially at the local level. The Kwazulu-Natal (KZN) Eyecare study was undertaken as an epidemiological study to evaluate the prevalence of vision loss and various sight-threatening conditions in the Lower Tugela health district of the KwaZulu-Natal province. Study data was used to develop a Blindness Prevention Tool (BPT) to assist in the planning and monitoring of eye care programs at a district level. h is intended that this SPT could be used to help develop model eye care delivery systems in areas with similar demographics, by inputting simple relevant local background data and predicting the human resources needed, providing a simple way of calculating key indices of progress and helping construct consistent reporting processes and documents. Aim: To develop a blindness prevention tool for planning and monitoring of eye and vision care by utilising the epidemiological data from the Lower Tugela health district Methodology: A comprehensive population-based study of blindness and visual impairment was conducted to develop a profile of the Lo\\'er Tugela health district. A cross-sectional study was conducted on a randomly selected sample of 3444 individuals from the district. Quantitative data from the epidemiological study was mined to develop the Blindness Prevention Tool (BPT). Results: 6.4% of the population studied were visually impaired. The main causes of visual impairment (presenting vision in the best eye of less than 6/18) were refractive error (44.5%), cataract (31.2%), glaucoma (6.0%), hypertensive retinopathy (4.1%) and diabetic retinopathy (1.4%). Thirty-one subjects (0.9%) were bilaterally blind with the main causes being cataracts (54.8%) and refractive error (12.9%). Glaucoma and hypertensive retinopathy were responsible for 6.4% of bilateral blindness. Diabetic retinopathy, other retinal conditions (Coloboma) and corneal scarring were each responsible for 3.2% of bilateral blindness. Albinism, Coloboma and AMD accounted for 9.7% of bilateral blindness. The Blindness Prevention Tool developed using the prevalence data was used to project human resource needs; generate basic epidemiological calculations and provide standardized reporting to motivate national coordinators and eye care managers to engage in reporting and monitoring. Conclusion: This study reflects the value of epidemiological evaluations beyond just describing trends in different communities. Integrating epidemiological data in program work can ensure maximum output from eye care programs by ensuring good planning, monitoring and reporting activity

Implementing a Two-Tiered Model of Optometry Training in Mozambique as an Eye Health Development Strategy

Background: The global burden of vision impairment has been acknowledged by the World Health Organisation as a public health challenge. In order to scale up the production of eye health personnel in developing countries, a tiered model of optometry training was explored in Mozambique

Recruitment and Selection Strategies in Optometric Education Towards Addressing Human Resource Disparities in Sub-Saharan Africa

The dire need for eye care services and a dearth of human resources (HR) in sub-Saharan Africa motivated the setting up of new optometry programmes. However, to make a meaningful impact, geographical, gender, economic and educational disparities must additionally be addressed. A qualitative study utilizing purposive sampling to select academic leadership and students from optometry programmes in sub-Saharan Africa was conducted. Individual and focus group interviews produced data that were coded and analysed using a deductive thematic analysis approach. The themes that emerged as contributing to disparities in access through recruitment and selection were institutional barriers (student intake numbers, programme marketing, minimum entry requirements, absence of pre-medical programme) and socio-economic barriers (finance, poor secondary school education, lack of knowledge of optometry, geographic location of institutions, gender). To address equity, institutions should engage with communities, market via community radio stations, offer pre-medical and bridging programmes, partner with governments and private funders to offer loans and bursaries and affirm females and rural applicants in recruitment and selection. In conclusion, universities must be socially accountable in all facets of education including recruitment and selection

Optical products for refractive error and low vision

This article will focus on the optical products required for the efficient delivery of refractive error and low vision services, and provide insight into how they can be managed effectively to ensure a quality service. You can consult the IAPB Standard List (see page 30) for suggestions regarding the optical products you may require at your facility as well as recommended suppliers

Patient Perspectives on Acquiring Spectacles: A Cambodian Experience

Purpose: To assess the perspectives of patients who acquired spectacles from an eye unit/vision center in Cambodia. Design: A sample (n = 62) of patients was selected across 4 provinces: Prey Veng, Siem Reap, Battambang, and Takeo. Methods: The Patient Spectacle Satisfaction Survey covering demographic and semistructured questions regarding patient satisfaction, style, and costs incurred was used to collect data. Information was transcribed and translated into English and analyzed by thematic coding using NVivo. Results: Although there were more women seeking eye health care treatment, there was no significant age difference. Patient satisfaction levels were high although the patients had to pay for transportation, registration, and the glasses themselves. A total of 60 patients (96.7%) stated they would recommend the refractive service center to others. Despite a high level of awareness of eye disease such as cataract, only 2 in 10 people could accurately identify cataract as a major cause of poor vision or blindness. Most of the people (52%) blamed bad vision or blindness on dust or other foreign objects getting into the eye, old age (31%), or poor hygiene (16%). Conclusions: Most people will pay eye care costs once barriers to seeking treatment have been broken via education and encouragement. Satisfaction of wearing spectacles was associated with improved vision; style, color, and fit of the spectacles; and protection from sunlight and dust. The proximity of and easy access to health facilities influenced patient desire to seek treatment

Willingness To Pay For Improved Vision In Mozambique

The burden of vision impairment due to uncorrected refractive error (needing spectacles) in Mozambique is known to be significant. To improve the planning and provision of eye health services, a better understanding of how vision is valued by patients is needed. The willingness to pay (WTP) for improved vision through correcting refractive error was investigated in Nampula, Mozambique, using stated choice and bidding game methodologies. The mean WTP values were found to be 388.92 Meticals (US$13) for stated choice and 469.89 Meticals (US$16) for the bidding game. The mean WTP values for rural dwellers were found to be lower than responses from those living in urban areas. If avoidable vision impairment is to be addressed in Mozambique, the cost of services must not be a barrier and the construction of a sustainable spectacle system that delivers for both rural and urban patients must be a priority

Modelo formativo de múltiples entradas y salidas en Salud Visual

Es por todos aceptado, que los modelos formativos a seguir son aquellos que siguen los patrones de los países más desarrollados. Estos modelos formativos basan su éxito en formar cualificados estudiantes que adquieren niveles elevados de conocimiento que les permitirá dar respuesta a avanzados problemas. Sin embargo este tipo de modelos formativos no siempre soluciona los problemas reales en países con niveles inferiores de desarrollo. El modelo formativo que recoge este CD adecua los sistemas formativos a las necesidades reales de cada sociedad, y en concreto en las áreas geográficas donde los niveles de pobreza exigen respuestas a corto plazo. Es el caso concreto de la Salud, y mas específicamente en la Salud Visual, el Modelo de múltiples entradas y salidas en Salud Visual, permite formar profesionales capaces de ofrecer un servicio de atención primaria básica, en países donde las condiciones de vida y la pobreza dificultan el acceso a la educación y a la sanidad. Un equipo de 14 profesores de las Universidades Politécnica de Catalunya (Barcelona España) y Kwa-Zulu Natal (Durban Sudáfrica) se ha encargado de elaborar sus contenidos. Estos profesores son expertos en cada una de las temáticas que recoge el CD

Relationship between biometry, fovea, and choroidal thickness in Nigerian children with myopia

Background: Understanding the relationship between biometric and structural changes in childhood myopia is necessary to effectively manage myopia progression. Aim: To determine the relationship between ocular biometry, fovea and sub-fovea choroidal thickness in school-aged children with myopia of Nigerian descent. Setting: Abuja, Nigeria. Methods: This study involved 189 children (117 girls and 72 boys), and myopia was defined as cycloplegic spherical equivalent refraction (SER) of ≤ −0.50 D. Keratometry values, biometry data, fovea and sub-foveal choroidal thickness (SFChT) values were obtained from medical records retrospectively and analysed. Results: The median age was 13 years (interquartile range [IQR]: 5). The median SER, fovea and SFChTs were −2.63 D (IQR: 3.38), 249 μm (IQR: 118) and 225 μm (IQR: 341), respectively. Male children had flatter corneas, thicker fovea and thinner SFChT compared to female children. The vitreous chamber and axial length were longer and sub-fovea choroid was thinner in children with high myopia. There was a weak but significant positive correlation between myopia and sub-fovea choroidal thickness (r = 0.270 respectively, P  0.01). A moderate negative correlation was found between myopia and vitreous chamber depth (r = −0.536, P  0.001), and a strong negative correlation was found between myopia and axial length (r = −0.706, P  0.001). Conclusion: Myopia in school-aged Nigerian children is associated with sub-fovea choroidal thinning, increased vitreous chamber depth and axial elongation. Contribution: This study provides data on the relationship between ocular biometry, fovea and sub-foveal choroidal thickness in school-aged Nigerian children with myopia