Hearing and Vision Integration at the Primary level

July 2014

Peter Ackland, CEO.IAPB

<10% of people who need eye care utilize eye screening camps

Vision Centres

Staffing

1 Technician

1 Coordinator

1 Eye Health Field Worker

Infrastructure

• Refraction Cubicle

• Slit Lamp

• Computer, Web cam

• Satellite Connectivity with Base Hospital

• Optical dispensing unit

• Autoclave

• Generator

Services Offered• Preliminary

Examination

• Refraction

• Urine/Blood Test

• Blood Pressure

• Consultation with Ophthalmologist through Video – Telemedicine

• Eye health education through Counseling

• Glasses & Medicines dispensing services

Primary Ear and Hearing Care pilot project

Dr Shroff’s Charity Eye Hospital, Sound Hearing 2030 & CBM

Two Vision Centres in Mustafabad (Delhi) and Rajgarh (Rajasthan)

• Vision Centre Technicians – 3 months training in ear and hearing (WHO intermediate module for PEHC workers)

• Provision of essential equipment (Otoscope, Bull’s lamp, Head Mirror, Tuning fork, syringe cannula, kidney tray and boiler)

• Community sensitisation – ear health awareness materials + combined ear and eye screening camps

Very positive evaluation - integration at primary level is possible but some concerns about scalability.

Nepal Netra Jyoti Sangh Biratnagar Eye Hospital, Biratnagar

12,416 Ear patients examined 201 Ear surgeries

222,457 Eye patients examined 52,979 Eye surgeries

67 joint eye and ear camps conducted

Nepal Netra Jyoti Sangh Programme Development

2014• Ophthalmic assistants receiving

training in ear problems.

• Six District Eye Care Centres started to provide ear care services.

Future• Ophthalmic Assistants in all remote

areas to be trained.• ENT surgeon to be deployed in 5 tertiary level eye hospitals.

IMPACT e.g. Lifeline Express India

Zanzibar Outreach Programme

School Programmes

FRESH (Focusing Resources on Effective School Health)

Vision and Hearing Thematic Indicators included in the Monitoring and Evaluation Guidance for School Health Programs

Global Partnership for Education

EFAVI Campaign - ICEVIDisability was a big issue at the recent GPE funding replenishment conference  

Barriers to integrating ears with eyes:

• Attitudes & silo working

• From an eye care providers view: the need to invest in many other aspects – technology, training & skills development, supply chain of drugs and hearing aid, referral links, etc.

E Evidence

A Awareness, Advocacy, Attitude

R Resources – financial + information

S Sharing, Showcasing, Stamina, Scaling