Integrating Traditional Services within Primary Health Care - Indian
Integrating Primary Eye Care and Primary Health Care 17 th Sept 2012
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Transcript of Integrating Primary Eye Care and Primary Health Care 17 th Sept 2012
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Integrating Primary Eye Care and
Primary Health Care17th Sept 2012
Dr Padmaja Kumari Rani,M.S,FNB (Retina)Head, Village Vision ComplexInternational Centre for Advancement of Rural Eye Care (ICARE)L V Prasad Eye InstituteHyderabad
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Acknowledgement:Puwat Charukamnoetkanok, MD, Thailand
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IntegratingPrimary Eye Care
and Primary Health Care
• Why • What• How • Global Scenario – Thailand Case Study• Indian Scenario (OEU & LVPEI Case studies)• Challenges• Way forward
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Why?
• Holistic care
• Treating causes of causes
• Wide reach
• Sustainability
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What?
WHO
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What?
• Horizontal approach
• Team work
• Networking
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What?
WHO
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How?
• Location
• Areas of Integration
• Stake holders
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How?
Khan et al
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Global scenario-Thailand
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Global scenario-Thailand
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Global scenario-Thailand
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• Launched in 1963
• 15 Projects
• 11 Partners
• 9 States & UT
• 3.4 million - people
covered
• 0.75 million – persons
directly benefited
HBCEHP –
USEHP –
OE India -
Indian scenario – OEU Operation Eye Sight Universal – India
•Immunization coverage •ANC/ PNC coverage has reached 100%•Increased Awareness levels
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Indian scenario – LVPEI
To eliminate avoidable blindness through
integration of Primary eye care with Primary health
care by community Development Initiatives.
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Who is a Vision health guardian
•Local village person
•Literate
•Healing touch
•Health worker background
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LVPEI (2010-2012)
• One tiny Village (5 months) – n-746
• Mandal ( District Subunit) – 54 villages with (2011-14) n-39,000
• Present Coverage – 70 villages -n-100,000
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Methodology
i. Identification and Training of Village Vision Health Guardians
i. Awareness creation
ii. Service delivery
iii. Community Development Initiatives
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Methodology I . Identification and Training of Village Vision Health
Guardians and village vision committee formation
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Methodology
II. Awareness creation
Teacher conducting Eye screeningTeachers Training Program
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Methodology
III. Service delivery
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MethodologyIV: Community Development Initiatives
JSS trade training program inauguration JSS trade training program in house wiring and electrical maintenance for village youth
Vision Garden Inauguration
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Coverage of One Mandal -54 Villages
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Situational Analysis of Study area
Illiteracy in Jainad Mandal 39.45 % - very low in females
% of population below poverty line >26%
Pattern of agricultureDry crops / irrigated dry crops cultivation due to lack of perennial source of irrigation
InfrastructurePoor Drainage / Sanitation / Power supply, roads etc.,
Employment opportunitiesMeager, due to lack of industries or arable lands and low scope for self employment
Type of houses 50% Semi pucca
Gas connection 30%
Individual toilets attached to houses 26%
Average percapita annual income
Rs 29,187/-
GDP : 8,786 crores [2007-2008]
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Project Survey Data
Slums/Villages surveyed 54Houses surveyed 9,538
Population covered through door to door survey 38,829
Diabetes high risk [score>60] 56Known diabetics identified (2.5%) 1,006Known Hypertension (3.4%) 1106Identified with High BP > 140/90 by VHG 221Identified with disability [All category] 103People identified with eye ailments and referred for eye examination
2,740
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Project Survey Interim Data
• Blindness (<6/60)-0.4%• Visual Impairment (<6/18)-7.1%• Spectacles prescribed- 664• Spectacles Purchased-354 (53%) children-35• Cataract Identified – 771• Patients visited SC-491• Cataract surgeries done-122
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Project Survey Interim Data
• Eye health and Primary health education events conducted -363
• n-2,877 • Number of pregnant women in the covered
villages - 408• Antenatal care-408 , Postnatal care-140
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Qualitative Impact
Master SaiKumar
Three VHGs – enrolled as Vision technicians
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Challenges
• Slow Process• Linkage with health care providers• Understanding Motivators/Barriers for
performance of VHGs • Measuring the Impact
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Way forward
• Cost effective Technology Innovations
• Care of the Community, by the Community and for the Community
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“Thousands of candles can be lit from a single candle, and the life of the candle will not be shorter. Happiness never decreases by being shared.”
The Buddha
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L V Prasad Eye Institutewww.lvpei.org
Thank you!
Excellence
Equity
Efficiency