Role of Non Governmental organisations in achieving universal eye halth in India

Non governmental organisations play a vital role in creating innovative models of delivering care to the most vulnerable secitons of the community. Their potential role goes much beyond service delivery

1. DR SANDEEP BUTTAN
MS, MPEH (LSHTM, UK)
ROLE OF NON-GOVERNMENTAL ORGANIZATIONS IN
PROVIDING UNIVERSAL EYE HEALTH COVERAGE IN
INDIA

2. Clinical Ophthalmologist & Cataract surgeon
Public health & Health systems Specialist
Design thinking, Strategic planning, Problem solving
Digital health & Health technology innovation enthusiast
•Medical advisor Eye health programs – Sightsavers India
•Consultant anterior segment & Cataract – Dr Shroff’s Charity eye hospital
•Medical Advisor (Ophthalmology) – VentureBlick
•Eye health systems consultant– Equipment / AI developers
•Certified RAAB trainer, S.Asia
•District Eye Health Systems Assessment (DEHAT) tool
•Epidemiological, Operational and Impact research

3. NON-
GOVERNMENTAL
ORGANISATIONS
(NGOS) IN EYE
CARE

4. NGOS IN EYE HEALTH
•WHY EYE HEALTH?
•SCOPE AND CHALLENGES
•LEVELS OF INTERVENTION
•EYE HEALTH ECOSYSTEM APPROACH
•FORESIGHT

5. HEALTH
“a state of complete physical, mental
and social wellbeing and not merely
an absence of disease or infirmity”.
It also includes the ability to lead a
socially and economically productive
life”
Preamble to the Constitution of the World Health Organization as adopted by the
International Health Conference, New York, 19-22 June, 1946;

6. IMPROVED EYE
HEALTH
SPILLOVERS TO
SYNERGIES
Health
•Improved Quality of Life
•Reduced morbidities and mortality
•Improve child survival
•Improve access to Health services (preventive, curative)
Social
•Reduce Poverty & Hunger
•Increase independence & social networking.
•Gender equality
•Acceptability of social interventions
Economic & Developmental
•Increased employability & productivity.
•Reduce financial burden.
•Education (improve school performance)
•Improved capacity/ willingness to pay for other services.

7. AVOIDABLE BLINDNESS
Avoidable?
Blindness &
Visual
Impairment
Eye disease
& their
progression
Loss of
productivity
Human
Capital &
Economic
loss
Burden on
families and
society
Needless
Human
Suffering

8. AVOIDABLE BLINDNESS
Avoidable?
Blindness &
Visual
Impairment
Eye disease &
their
progression
Loss of
productivity
Human
Capital &
Economic
loss
Burden on
families and
society
Needless
Human
Suffering
LINKED TO THE VISION AND MISSION

9. EYE HEALTH:
INEQUITIES

10. EYE HEALTH: INEQUITIES
DEMAND
SUPPLY

11. EYE CARE
CONVENTIONAL APPROACH
•Vertical / stand alone structure and activities.
•Relatively simple (but effective) disease specific
interventions (Cataract, RE) .
•Dedicated National and/ OR International funding.
•Duplication of resources.
•Limited focus on long term sustainability

12. EYE CARE
CHANGING SCENARIOS
Changing
demographics: Ageing
population
Growing complexity of
morbidities: Glaucoma,
Diabetic retinopathy,
ROP, AMD etc
Shrinking funding pool
Emerging health issues
(NCDs)
Need to Scale up with
Sustainability
Better understanding
of wider risk factors
and enablers

13. INEQUITY TO UNIVERSAL COVERAGE

14. UNIVERSAL HEALTH COVERAGE
“Ensuring that everyone has access
to the health services they need
without causing financial hardship”
More than just providing medical
care:
“enhancing health, social cohesion
and sustainable human and
economic development”

15. UNIVERSAL (EYE) HEALTH COVERAGE
POPULATION COVERAGE
(REACH OUT TO UNREACHED)
SERVICE COVERAGE
(BEYOND CATARACT & URE)
FINANCIAL COVERAGE
(REDUCE OUT OF POCKET EXPENSES)

16. IS COVERAGE
ENOUGH?
•Quality
•Integration
•People Centric
•Sustainable
•Responsive
•Evidence driven (driving)

17. STAKEHOLDERS
Governments (National & State)
Min. of Health, Education, Labor, social welfare,
legislative, Industries & Taxation
Health providers
Hospitals (Govt, NGO: not for profit, Private: for profit)
Medical professionals (Doctors, Nurses, Paramedics)
Educational & professional
bodies
Medical & Para-medical council
Standards Controlling agencies.

18. STAKEHOLDERS
•Industry
•Medical (Pharmaceuticals & Med.
Equipment, Software)
•Media & IT
•Financial bodies (banking, insurance)
•Other development agencies
•Community

19. HEALTH SYSTEMS
FRAMEWORK
“All organizations, people and actions
whose primary intent is to promote,
restore or maintain Health”

20. WHAT SHOULD NON-
GOVERNMENTAL
AGENCIES FOCUS ON?

21. STRATEGIC FOCUS AREAS
National/
International level
Regional/ state
level
Program/ project
level
Service Delivery
level
“Continue to do what is being done and has been
giving good results already”

22. NGO ROLES
Non-Service Providers
•Resource mobilization
•Advocacy & policy engagement
•Strategic planning
•Capacity building
•Systems integration
Service providers (Hospitals)
•Service delivery
•Community mobilization
•Quality assurance
•Technical capacity
•Technology integration

23. PROGRAM/ PROJECT LEVEL
Service Delivery: ensuring
Quality & Equity
Systems mapping during
project planning.
Ensure maximum utilization
of existing systems/ health
resources (manpower,
networks)
Quality Assurance at all
levels (Inputs, Process,
outcomes)
Evidence generation
(Information systems &
Systems level impact
analysis)

24. TAKING PRIMARY EYE
CARE TO WHERE THE
PEOPLE ARE
Tea Garden workers in Alipurdwar

25. TAKING PRIMARY
EYE CARE TO
WHERE THE
PEOPLE ARE
‘One person at a time’

26. TAKING PRIMARY EYE CARE TO WHERE THE PEOPLE ARE
Screening Truck drivers at Transport Hubs

27. PRIMARY ‘HOME (EYE) HEALTHCARE’
…reaching the truly unreached

28. PEC INTEGRATION PHCS AND CHC

29. COVERAGE ELEMENTS
Utilization
AccessAvailability
COVERAGE
Effective
COVERAGE
Good
Outcome

30. STRENGTHENING SYSTEMS AT PRIMARY LEVEL
•Processes •People•Equipment

31. USING TECHNOLOGY

32. CLOSING THE LOOP… KEEPING TRACK..
•Maintaining data •Referral compliance

33. REGIONAL/ STATE LEVEL
Human Resource
•Need based HR development initiatives (comprehensive
doctors/ medical professionals)
•Training: Innovative short- and long-term strategies
•Empowered grassroots & mid level (Short term)
•Encourage “Training of trainers” (Long term)
•Incorporate essential elements in all training curricula (long
term)
•Task sharing at primary level: utilization of existing manpower.

34. NATIONAL/ INTERNATIONAL LEVEL
Governance & Leadership
ADVOCACY
•Health policies & commitments towards UHC
•Present evidence (local & international initiatives)
•Guide policies
•Resource allocation
•Health budget
•Provisions in non-Health budget (education, labor, social
welfare)
•Health care financing models

35. CROSS CUTTING PRINCIPLES
•Aiming for Universal Access & Equity
•Evidence based planning & monitoring
•Community involvement and ownership
•Inclusive development of people with disabilities.
•Ensuring Quality with sustainability
•Efficient utilization of technology

36. KEEPING PEOPLE IN THE CENTER

37. THANKS FOR
YOUR ATTENTION
[email protected]
[email protected]