1 / 38

Extending eye care to rural Nigeria: The Vision2020 Eye Clinic Ukpor experience

Extending eye care to rural Nigeria: The Vision2020 Eye Clinic Ukpor experience. Sebastian N N Nwosu Cyriacus U Akudinobi Guinness Eye Center Onitsha Nigeria . Nnamdi Azikiwe University Awka. Guinness Eye Center Onitsha. Declaration . No financial interests. Introducton .

meagan
Download Presentation

Extending eye care to rural Nigeria: The Vision2020 Eye Clinic Ukpor experience

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. Extending eye care to rural Nigeria: The Vision2020 Eye Clinic Ukpor experience Sebastian N N Nwosu Cyriacus U Akudinobi Guinness Eye Center Onitsha Nigeria

  2. Nnamdi Azikiwe University Awka

  3. Guinness Eye Center Onitsha

  4. Declaration • No financial interests

  5. Introducton • Eye diseases and blindness are of public health importance in Nigeria

  6. Political map of Nigeria

  7. Introduction...2 Estimated blindness rate in Nigeria Blindness prevalence in Nigeria • The national blindness & low vision survey reported in 2008 that 46 out of every 1000 adults aged even 40 years and above were blind

  8. Position of Anambra State in Nigeria

  9. Introduction...3 • In Anambra State the prevalence of blindness is even higher • The rural-urban migration notwithstanding, majority of the populace still reside in rural areas

  10. Typical village gate

  11. Typical rural house

  12. Introduction...2 • Anambra State is one of the 36 states in Nigeria • Divided into 21 local government councils, it has the Ministry of Health that regulates and oversees health care delivery especially at secondary care level throughout the state • The local governments are in-charge of primary health care activities

  13. Introduction...3 • Health care services are provided by both the government and the private entrepreneurs • However the latter tend to concentrate in urban areas • Generally the rural areas are poorly served

  14. Water source in rural areas

  15. Eye care in Anambra State • There is only one publicly-owned eye hospital in Anambra State – the Guinness Eye Center Onitsha • Two other sparsely staffed eye units exist in government run hospitals • Private eye care facilities exist but these are located in the urban cities

  16. Anambra Strategic Health Plan • To ensure optimal health for the people the government drew up the 2010-2015 strategic health development plan • But this 74-page document has nothing on eye care

  17. Previous efforts... • Outreach eye camps... • Poor follow-up • Not sustainable • Ownership taken by people • Seen as occasional patronage from enthusiastic urban dwellers

  18. Static eye care facility sought • Dissatisfaction with intermittent eye camp programme led to a shift in approach viz: • Possibility of establishing static eye care facilities in rural areas: • churches, town unions, influential persons, government officials were contacted

  19. Collaboration for eye care • In order to bring quality eye care to the rural dwellers in the state the Nnamdi Azikiwe University collaborated with Nnewi-South Local Government Council to establish the Vision2020 eye clinic at Ukpor • This paper reports the experience in the first year of services in the clinic

  20. Memorandum of Understanding • Idea of establishing the clinic originated from the Ophthalmology Dept Nnamdi Azikiwe University • A memorandum of understanding (agreement) between • Nnewi-South Local Government Council • Nnamdi Azikiwe University offically ensured the establishment of the clinic

  21. Stake holders’ responsibilities • Council: To provide infrastructure & equip the clinic • University: To provide ophthalmologists; provide technical support; train primary eye care workers; provide clinical services and conduct research • Community: To provide land & security • All: maintain advocacy for the eye clinic

  22. Developmental phases • Community awareness of the clinic’s existence • Clinical services • School eye health • Eye health promotion & education in the community • Self-sustaining services • Replication of the model in other communities

  23. Results • We trained 3 primary health care workers nominated by council in primary eye care • Publicity about the clinic existence mounted through de facto leaders in churches, marketplaces, women fora, town union, village meetings, etc • Clinical services commenced June 2011 • Surgical services became available a year later

  24. Results...2 • 166 new patients – seen; M:F = 1:1.6 • Age range: 1-88; mean- 48.8±15.2 • Blindness rate: 10.4% (7 male; 7 female) • Visual impairment: 17.7%(11 male; 18 female)

  25. Bilaterally blind led by son

  26. Bilateral cataract

  27. Causes of low vision

  28. Clinical diagnosis

  29. Comments • The establishment of the clinic took more than 5 years of planning & advocacy • At initial stage patronage was low • Patronage improved when the local elite was satisfied with the services - esp. optical services

  30. Comments...2 • Implementation of decisions delayed by • Government bureaucracy • Unstable council leadership (frequent transfers) • Industrial action by council & health workers

  31. Comments...3 • Low vision rate, though clinic-based, is high • Causes of low vision - largely avoidable • Most of the blind require cataract surgery • Patients blind from glaucoma presented late

  32. Comments...4 • Steady, dependable clinical services as well as community health education will expectedly encourage patients to present early • The quality of cataract surgery should not be compromised – better visual outcome ensures better uptake

  33. Sustainability...? • Our greatest worry & challenge

  34. Sustainability...2 • A clinic revolving fund to be established • Sliding scale of fees charged to ensure that the poor benefits

  35. Sustainability...3 • Continuing advocacy with the de facto leaders, including government and the local elite

  36. Future... • Establish such clinics in other local government councils • Draw 5 year strategic plan for eye care • Hopefully this will form the nucleus of Anambra State eye care plan

  37. Acknowlegdement... • Mr E Nwabuagha, Former Head of Service, Nnewi-South Local Government Council, Ukpor, Anambra State, Nigeria • Mr Dubem Obaze, Former Commissioner for Local Government and Chieftaincy Matters, Anambra State, Nigeria • Prof B Egboka, Vice Chancellor Nnamdi Azikiwe University, Awka, Nigeria • Dr Kunle Hassan, Eye Foundation Hospital, Lagos, Nigeria – for some surgical consummables • Deseret International Inc. Utah USA – for providing surgical consummables & cataract surgery instruments

  38. Adjourn... • Thanks for listening

More Related