Community Ophthalmology ophthalmology community

Community ophthalmology

1. NATIONAL PROGRAMME FOR CONTROL OF BLINDNESS AND VISUAL IMPAIRMENT (NPCB & VI) IN INDIA

2. INCEPTION AND PRESENT STATUS INCEPTION OF NPCB India was the first country in the world to launch the 'National Programme for Control of Blindness (NPCB) in year 1976 as 100% centrally sponsored programme with the goals: To provide comprehensive eye care facilities for primary, secondary and tertiary levels of eye health care, and to reduce the prevalence of blindness in population. In 2017 the name of the program was changed to “National Programme for Control of Blindness and Visual Impairment (NPCB & VI)”.

3. MAIN OBJECTIVES To reduce the backlog of avoidable blindness Develop and strengthen the strategy of NPCB & VI for "Eye Health for All" Strengthening and up-gradation of Regional Institutes of Ophthalmology (RIOs) Strengthening the existing infrastructure facilities and developing additional human resources To enhance community awareness on eye care Increase and expand research for prevention of blindness and visual impairment To secure participation of voluntary organizations /private practitioners in delivering eye care.

4. PROGRAMME ORGANIZATION AND IMPLEMENTATION  Since 2021, NPCB & VI is being implemented as per guidelines of the initiative 'Vision 2020: Right to Sight. During 12th Five Year Plan (2012-2017), from the financial year 2013-14, it has been decided to continue the NPCB & VI under the NCD flexipool within the “National Health Mission.” The contribution of the central government will be 75% and that of state/UT government will be 25% of the total fund requirement for NPCB & VI.

5. ADMINISTRATIVE SETUP Various programme activities implemented at central, state and district levels are as follows : 1. Central level At the central level, programme organization is the responsibility of the 'National Programme Management Cell' located in the office of Director General Health Services (DGHS), Department of Health, Government of India (GOI). T here are three national bodies have been constituted to oversee the implementation of the programme as below: National Blindness Control Board, chaired by Secretary Health to GOI. National Programme Coordination Committee, chaired by Additional Secretary to GOI. National Technical Advisor Committee, headed by Director General Health Services, GOI.

6. Central level activities include formulation of policies and guidelines for all activities related to eye care such as: Procurement of goods (major equipment, bulk consumables, vehicles, etc.)  Nonrecurringz grant-in-aid to NGOs.  Organizing central level training courses. Information, education and communication (IEC) activities (prototype development and mass media). Development of MIS, monitoring and evaluation. Procurement of services and consultancy. Salaries of additional staff at the central level.

7. 2. State level The NPCB is implemented through the State Government Via 'State Ophthalmic Cell’. All the work related to blindness control shall be routed through State Programme Officer/ j oint Director (ophthalmology) in-charge of NPCB & VI. 'State Blindness Control Society' (SBCS) has been merged with State Health Society after launch of National Health Mission(NHM) for implementing the programme at the state level. State Health Society (Blindness Division): The primary purpose of the State Health Society (Blindness Division) under the NRHM is to plan, implement and monitor blindness control activities in all the districts of the state as per the pattern of assistance approved for National Programme for Control of Blindness and Visual Impairment (NPCBVI) by the Mission Steering Group (MSG) in centre.

8. Composition Chairman: State Mission Director/Secretary. Vice-Chairman: Director Health Services Member Secretary: Joint/Dy. Director (from the state cadre) Functions- To coordinate and monitor with all the District Health Society. To conduct regular review meeting with districts in coordination with centre. To procure equipment and drugs required in GOI facilities. To receive and monitor use of funds equipments and material from the government and other agencies. To involve voluntary organization and private practitioners providing free/ subsidized eye care services in district and identity NGO facilities that can be considered for nonrecurring grants under NPCBVI. To promote eye donation through various media and monitor the districts for collection and utilization of eyes collected by eye donation centers and eye banks and directly identify NGO facilities that can be considered for grants under NPCBVI.

9. 3. District level 'District Blindness Control Societies' were established to organize the programme at district level.Under National Health Mission' the programme activities are to be implemented through ‘District Health Societies.’ District Health Society- The District Health Society has a maximum of 15 members as detailed below: Chairman: District Collector/District Mission Director. Vice-Chairman: Chief Medical and Health Officer/District Health Officer. Member Secretary: Officer of the level of Deputy CMO preferably an ophthalmologist may be designated as District Programme Manager (DPM) who would also be the Member Secretary of the society.

10. Technical Advisor: Chief Ophthalmic Surgeon of District Hospital. In districts where Medical Colleges are located, Head of the Department of Ophthalmology. Members: Medical Superintendent/Civil Surgeon of District Hospital District Education Officer (IMA, District chapter of AIOS, etc.), representatives from NGOs engaged in eye care services, District Mass Media/IBC officer; prominen t practicing eye surgeons.

11. Important functions- To assess the magnitude and spread of blindness in the district by means of active case finding village-wise to be recorded and maintained in Blind Registers. To organize screening camps for identifying those requiring cataract surgery and other blinding disorders, organize transportation and conduct of free medical or surgical services including cataract surgery for the poor in government facilities or NGOs supporting the programme; To plan and organize training of community level workers, teachers and ophthalmic assistants/nurses involved in eye care services; To procure drugs and consumables including micro-surgical instruments required in the government facilities; To receive and monitor use of funds, equipments and materials from the government and other agencies/ donors;

12. To involve voluntary and private hospitals providing free/ subsidized eye care services in the district and identify NGO facilities that can be considered for non-recurring grants under the programme; To organize screening of school children for detection of refractive errors and other eye problems and provide free glasses to poor children; To promote eye donation through various media and monitor collection and utilization of eyes collected by eye donation centers and eye banks. The PMOAs (Paramedical Ophthalmic Assistance) shall be doing the regular screening for cataract and other diseases in the outreach camps. They shall be under the direct control of the District Ophthalmic Surgeon/DPM. The TA/DA of the PMOA is for the outreach camps conducted shall be paid by District Health Society.

13. PLAN OF ACTION AND ACTIVITIES 1) Extension of eye care services Through eye camps and mobile eye units. Development of multipurpose district mobile ophthalmic units (MDMOU) has been introduced with an objective to further expand eye-care coverage in remote and underserved areas. Tele-ophthalmology network units with linkage to ophthalmic consultation units in the Medical Colleges and RIOs are to be set up.

14. 2) Establishment of permanent infrastructure Primary eye care, at peripheral level (PHCs and subcentres ) is being strengthened by: Providing necessary equipment, Posting a paramedical ophthalmic assistant, and Organising refresher courses for doctors and other staff of PHC on prevention of blindness. Secondary eye care, at intermediate level, Tertiary eye care, at central level, and Center of excellence, at apex level for high quality tertiary eye care, and to provide guidance and leadership for technical matters. 3) Intensification of eye health education Government of India adopted ‘Vision 2020: Right to Sight' under 'National Programme for Control of Blindness’ and constituted a working group to plan the action and activities implemented up to March 2026.