© Sightsavers

IAPB 9 GA

Primary eye care 2020 & beyond

Hannah Faal

© Sightsavers

Summary

Trends Demography transition Population transition Epidemiological transition Population development phases and stages Extent of primary care The meeting point

© Sightsavers

Trends

1978 Primary health care

1999 Vision 2020: The Right to Sight

2007 The PEC working group formation

2008 PHC: Now more than ever 2008, the reforms

2012 Universal health coverage: health as a right

Change over time ?

VISION 2020, any level of sight as a right

VISION 2020: elimination of avoidable blindness.

elimination of avoidable visual disability

© Sightsavers

Globally –

Primary eye care for the two extremes: aged and ageing and the premature

Demography transition

an ageing population

an ageing population

survival of the premature

survival of the premature

© Sightsavers

Population transition

Urbanisation Urbanisation Rural PECRural PEC

Urban PEC suited to the urban structure• Rapid pace of change• Urban poverty • Lack of the traditional supportive network

Increasing engagement with social determinants of health

© Sightsavers

Epidemiological transition

The urgency and benefits of integrated programmes and a holistic approach

Elimination of communicable causes of visual loss

Elimination of communicable causes of visual loss

Eye NCDs: cataract, RE, presbyopia, glaucoma, ARMD etc

Eye NCDs: cataract, RE, presbyopia, glaucoma, ARMD etc

Non – EyeNCDs:

Diabetes

Non – EyeNCDs:

DiabetesPrimary care and ocular morbidity-increasing awareness

Primary care and ocular morbidity-increasing awareness

© Sightsavers

Population development phases and stages

The people/population functions as stewards, consumers, providers, financers of health

Their performance and needs in each phase and stage of the population’s development

e.g: Health promotion: adaptation and changes in content and strategy to match

ceh_11_25_004_f01

© Sightsavers

Population development phases and stages

Into every home takes on a different meaning in each phase and stage• rural area by health worker, use of a poster • The TV • The mobile phone• The internet

Customisation of PEC to suit function and phase/stage.

© Sightsavers

Extent of primary care

• With increasing development and awareness of a population on the one hand

• With the increase in life time diseases and chronicity

Eye health in primary care will need to adapt and integrate with these changes

• What is offered: the extent of care• Who offers it: Task shifting/sharing• Self care: self check for diseases • Nature of function of front line health facilities: e.g.

screening, maintenance management of chronic diseases.

© Sightsavers

The meeting pointPrimary care is the coalescing point of the interaction of health

and every other business:• Social determinants• All institutions, organisations whose primary intent is not

health but whose decisions, actions impact on health• All institutions, organisations whose primary intent is

health– health systems

Today, Eye health knows eye health business

Eye health needs to know every other business

Primary care is where eye health is made everybody’s business.

Now to 2020 and beyond.