Eye care

Introduction on the eyes programs: –

The organization focused on working in the eyes programs independently and more specialized in the public primary health care programs in order to participate in the issue of the adoption of the Prevention of Blindness and the reduction of the causes that can be avoided amid the various categories of citizens from the poorest of the poor and the marginalized (children – women – older persons) which rises among them the Incidence rates of the blindness disease and foe hat the eyes represent as it is the external window through which human communicates with the outside world around him and it is window we watch what’s inside of the secrets of the human body and that the loss of sight has humanitarian, social and economic consequences for the individual and society and what prompted the organization to contribute and to work in the eyes programs is the daily accumulation from detected cases that infected with eye disease and that from its subordination according to the World Health Organization indicators is that: –

  • Every five seconds an adult loses his sight
  • Every minute a child loses his sight
  • There are about 45 million blind citizen
  • 135 million from the world are partially sighted people
  • Every year the number increases with a rate of 1-2 million citizens
  • Without proper and appropriate intervention the number of blind people will reach to 75 million by 2020

So it was necessary for the organization to adopt the issue of the fight against blindness through the eyes programs and continue because in Egypt there are: –

  • 737000 Egyptian citizens have been deprived from the grace of sight
  • 800000 others crawling toward the dark with different eye diseases
  • Each year, the number of blind people in Egypt increases by about 150000 citizen
  • And this situation constitutes a major challenge not only for the eyes programs, but for the programs of development and the eyes programs relies in its presentation a comprehensive concept for the health care which includes prevention – education – community participation and trying to provide the right to sight as a fundamental human right that is available to him if the following elements are available in the service from abundance / quality / cost / awareness and thus there will be a proper intervention to control the main causes for the prevention of blindness

This guide aims to provide a unified general framework that helps the work teams in the sites to manage the implementation of the eyes programs with international work objectives and strategies unified and agreed upon by the World Health Organization and the International Agency for Prevention of Blindness

The general objectives that the eye programs seeks to achieve: –

  • The elimination of avoidable blindness through the creation of a comprehensive and sustainable care system to secure the best possible sight among the poor and marginalized groups and thus improve the quality of life
  • Create bridges between communities that are in need of eye health services and between this service providers, especially in disadvantaged areas
  • The existence of awareness programs to control the major causes of blindness
  • Strengthening the necessary infrastructure from (institutions provide the ophthalmology service – clean water – Sanitation) to fight avoidable blindness
  • Human resources development and the formation of trained structures from Ophthalmology service providers and the community volunteer cadres from the civil society

Work strategies in the eyes programs to fight blindness and the elimination of the factors that cause these serious disability are the following: –

  • Control the disease by the examination, detection, therapeutic and surgical intervention.
  • Human resource development (training – incentives)
  • Develop and strengthen the infrastructure (facilities – appropriate technology)
  • Advocacy and lobbying to fight loss of sight.

Targeted categories by the eyes programs:

The first category: –

Children from the age of one day of birth until 15 years

The second category: –

The older citizens from 45 years old and above (Those who are outside the coverage of the health insurance) in the poor and marginalized communities.

The third category: –

From the age of 16 until 44 years through correcting the sight defects they have

Note: –

* These categories are more likely to blindness in accordance with the facts and indicators from (the World Health Organization and the World Agency for Prevention of Blindness).

Criteria for selection of the leaderships working in the eyes programs: –

In the eyes programs the basic roles played by the working leaderships are: –

  • Provide counseling service for the citizens
  • Preparing for the implementation of examination and discovery convoys and campaigns within the scope of their work or inside the educational institutions
  • Accompanying patients to make any advanced tests outside the scope of the community
  • Accompanied the patients to perform any surgeries outside the scope of the community
  • Preparation and processing for any meetings and gatherings to raise the awareness
  • Processing of the basic data for the citizens participating in the campaigns and convoys through forms
  • Prepare digital – foundational monthly reports

So there will be a criteria for the selection of leaders according to the roles assigned to it for implementation:

  • Holding an Intermediate education or higher education qualifications
  • From the same communities in which the eyes Programs are implemented
  • They have the skills of counseling and persuasion
  • They have marketing skills
  • They have the ability to deal with the institutions working in the ophthalmology service and other

The outputs of the eyes programs: –

The service provided to the eyes in Egypt so far is based on the medical services only in terms of diagnosis and the available treatment in the units and the government, national and private eyes hospitals but through the implementation of the eyes programs and the organization’s adoption of the right to sight for all initiative in 2020 the concept of health care was more comprehensive which include:

  • Prevention
  • Awareness
  • community participation

Provided that the outputs are:

  • The number of cases that have been discovered and treated and the early intervention with it
  • A list with the main causes of the eyes diseases
  • A list with the main causes of avoidable blindness either through the treatment or prevention
  • The number of cases conducted white water surgery
  • The number of cases conducted advanced tests
  • The number of cases have corrected the defects of vision to them through eyeglasses
  • The number of cases conducted keratoleptynsis for them
  • The number of cases conducted minor surgery
  • The number of cases progressing and getting better from diabetes who are impaired in the retina
  • The number of cases that have been preventing the deterioration of their disabilities
  • The number of cases that have been converted to the competent bodies
  • The number of seminars and number of attendees
  • The number of flyers and posters that have been distributed
  • The number of local and external partners in the implementation of the initiative

The indicators of achieving the objectives of the eyes programs: –

  1. The percentage of reaching the scheme compared to the targeted in the work areas
  2. Reaching to 80% from the targeted categories and 20% of other categories
  3. Provide eyeglasses to 90% of the discovered cases
  4. Correcting the field of visual acuity with some surgical interventions from 6/18 to 6/9
  5. The existence of databases on the size of the problem of eyes diseases and the service providers
  6. Percentages of the cases that have benefited from the decisions of treatment at state expense compared to the total beneficiaries of the service
  7. Number of performed environment initiatives related to eyes diseases and its causes
  8. The numbers of participants from the community in raising awareness meetings
  9. The numbers of participants from local and external partners in the implementation of the right vision for All initiative

The quality standards in the eyes programs: –

The quality standards in the eyes programs depends on treating the deficiencies in the eyesight functions for the citizens and children according to various medical interventions and internationally recognized

  1. Providing a good level surgery for the cataract patients (White Water)
  2. Providing a good eyeglasses, especially for children and reaching to 90% of the discovered cases
  3. Providing an effective and appropriate medicine according to the patient’s needs
  4. Providing appropriate intervention and good follow up for the cases of the minor surgeries and the critical cases
  5. Providing a good follow up for the cases of chronic eye diseases
  6. Providing health education in partnership with the citizens
  7. Filling the data related to the diagnosis form for each patient
  8. Measuring visual acuity and examining it with the computer before and after for the cases
  9. The percentage of reaching the scheme compared to the targeted
  10. Matching the standards of the targeted categories (age – residents of the area – outside the coverage of the insurance ………………
  11. Reaching to 80% of targeted categories and 20% of other categories
  12. Assessing the sight of children by measuring the visual acuity or any other means to measure it
  13. follow up diabetics, particularly the retina and eye pressure every 6 months periodically
  14. Performing 100% of the discovered???? Surgeries
  15. Perform cataract surgeries and lens implant for patients with Visual acuity less than 6/18
  16. Perform follow up after the surgeries and measuring the visual acuity and the fundus examination

The most important partners in the eyes programs: –

  • Ophthalmologists and ophthalmologists assistants and optics specialist and the nursing cadres
  • Non-governmental organizations and international institutions concerned with the development and training
  • The Ministry of Health and the departments of health services and health insurance
  • The private sector (companies of Pharmacology optics shops …………….. etc.
  • The Ministry of Education as it represents the largest segment of the beneficiaries in the age group from kindergarten until the end of basic education
  • General Authority for Potable Water and Sanitation
  • The media (visual – audible – readable) and its role in shedding light on the magnitude of the problem of the eyesight loss and the awareness of it

Legal frameworks and international resolutions and conventions relating to eye programs: –

  • Implementation of the eyes programs linked in accordance to a close link to an international agreement signed by a number of countries in 1998 which is The Right to Sight initiative or Sight 2020 to combat the loss of sight by all means and to eliminate all factors causing this disability by 2020 and signed by Egypt in 2003 in terms of solidarity between the World Health Organization and the International Agency for Prevention of Blindness and with the participation of a coalition of governmental and non-governmental organizations concerned with the treatment of eye diseases and blindness prevention and rehabilitation of the visually impaired as the organization adopts through the eyes programs the application and activating this initiative The Right to Sight for all by the same general strategies to avoid blindness according to the estimates of global indicators developed by the World Health Organization if there is no proper intervention the number of blind people in the world during 2020 will be up to 75 million, and if the intervention is done it will avoid 75% of the cases of blindness

Article 16 of the Constitution provides: –

The State shall guarantee cultural, social and health services and works to ensure them particularly for village in an easy and regularity to raise its level

Article 17 of the Constitution provides: –

The State shall guarantee social and health insurance services and disability pensions for the unemployment and aging for all citizens, in accordance with the law

Specific tools and methods used in the eyes programs: –

Many specific tools and methods are used in the eyes programs which are:-

  1. The existence of a presentation POWER POINT for health messages about the eye diseases used in meetings to raise the awareness
  2. The existence of a variety of publications (poster – flayers – …………… etc) contain health messages about eye diseases
  3. The existence of an educational guide for counselors
  4. Scale model of the eye
  5. The existence of (lens – torch) are used by the volunteer leaders in home visits
  6. The existence of signs boards are used to measure visual acuity
  7. The existence of a flipchart to provide advice from (Al Nour Charity Foundation)

Areas expected to expand in the future for the eyes programs: –

  • Expansion with other local partners to spread The Right to Sight initiative for all 2020, on a wide geographical reach
  • Supporting the partnership with the private sector
  • Activating the role of information systems for the patients
  • Giving priority to training and building specialized cadres at the level of the medical structures – the community leaderships
  • Increasing coordination and integration between Ophthalmology different service providers
  • Continuity in the implementation of the eyes programs in accordance with primary health care system which depends on (prevention – awareness – community participation)

Logical steps taken to implement the eyes programs: –

The service provided to the eyes in Egypt so far is based on the medical services only in terms of diagnosis and the available treatment in the units and the government, national and private eyes hospitals but through the implementation of the eyes programs and the organization’s adoption of the right to sight for all initiative in 2020 the concept of health care was more comprehensive which include:

  • Prevention
  • Awareness
  • community participation

The eyes programs work methodology are applied in according to several steps divided into stages

The first stage:-

  1. Choosing the work communities according to a geographical basis
  2. Conducting a field surveys to discover the magnitude of the problem of eye diseases and its percentage between the different categories, particularly among older persons, children and women within the work areas
  3. Selecting local partners from civil associations within the work areas and community cadres

The second stage:-

  1. Monitoring Ophthalmology service providers at the level of work areas and outside it and analyzing it
  2. Processing database explains the service providers and the cost of the service and the extent of its availability and abundance for the citizens
  3. Preparing the used administrators and the means of clarification and other technical assistive devices
  4. Technical and administrative training for the partners of the work communities
  5. The signing of cooperation protocols and the development of systems for the application of the referral with many of those systems
  6. The development of joint and written plan with the local partners
  7. Managing the financial and technical resources
  8. managing forms of advertising and marketing

The third stage:-

  1. Implementation of campaigns in the work areas from examination and discovery of the patients and conducting the appropriate interventions
  2. following up on a regular basis with the partners on the level of service provision and the local partners
  3. Continuity and attempt of self-management of the program depending on the local contributions

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