This East African country with a population of 55 million boasts of the highest mountain in Africa (Mt Kilimanjaro) and is also renowned for its wildlife and game parks. It is a predominantly rural country with an estimated 71 per cent of the population living in rural areas. According to the National Bureau of Statistics (NBS) Census of 2012, about 44.2 per cent of Tanzania’s population is estimated to be below 15 years of age.
The Foundation has made substantial effort to address the challenges of eye health in Tanzania and has spent the last decade supporting the Ministry of Health to improve access to quality refractive errors services in the public sector hospitals. Over the years it has set up 14 Vision Centres across the country, 12 in Tanzania mainland and 2 in Unguja and Pemba islands of Zanzibar. The Institute also implemented child and school eye health projects, conducted research and supported human resources development for eye health. The Foundation’s Academy in Australia conducted a faculty development program which sponsored faculty training of KCMC school of Optometry and the Kilimanjaro Christian Medical College, a constituent college of Tumaini University. The beneficiaries included 2 B.Sc. Optometry sponsorships, 1 Post graduate training sponsorship, 1 PHD sponsorship as well as Curriculum development support and supply of learning materials to the optometry training programme at Tumaini University. The Foundation has also supported CPD training for optometrists in the country.
- A Rapid Assessment of Refractive Error (RARE) and spectacle coverage study was conducted in Kahama district of Northern Tanzania in 2011 . The aim of the study was to determine the prevalence of refractive error and presbyopia, spectacle coverage and the barriers to uptake of refractive services in people aged 15 years and older. The findings of the research were published in 2014. Refractive error prevalence was 7.5 per cent and this was highest in participants over 40 years while the prevalence of presbyopia was 46.5 per cent. Spectacle coverage for refractive error and presbyopia was 1.69% and 0.42% respectively. The conclusion from this research was that uncorrected refractive error is a public health challenge in the Kahama district and sustainable service delivery and health promotion efforts were needed.
- A comparative analysis of a stand-alone and an integrated school eye health model in Zanzibar was conducted between 2016-2018. The aim of the study was to determine the most effective school eye model; standalone versus one integrated into a broader school health programme. The study compared the coverage of screening, spectacle usage and compliance and the implementation costs between the integrated and stand-alone school eye health model. The findings showed that even though integrated model used twice the resources compared to stand-alone model per child, there are great opportunities for cost sharing and saving, and achieve long term sustainability.
The findings of this study will be utilized for advocacy to influence school health policy for eye health programs not only in Zanzibar but globally. It also generates evidence-based decision making about efficient, effective approaches for school eye health programs so that resources can be efficiently utilized to reach all children with eye health care.
- Evaluation of a Child-to-Child approach among children to increase eye health screening, eye health services uptake and to improve eye health seeking behaviour in Bariadi District. The aim of the research was to assess the effectiveness of a Child-to-Child approach that trains school- going children to be Vision Champions, and evaluate whether the schools’ Vision Champion programme improves and contributes positively to good eye health behavior; furthermore, the research offered an opportunity to assess whether this innovative approach can be integrated into the school eye health system.
While Tanzania has optometrists employed in the public hospitals, for a long time refractive errors were not being effectively addressed because the optometrists did not have the equipment to work with. In view of this, the Foundation began to officially work in Tanzania in 2009 in partnership with the Ministry of Health. Over the years it has set up 14 Vision Centres across the country, 12 in Tanzania mainland in Iringa, Dodoma, Mwanza, Singida, Ruvuma, Mbeya, Mtwara, Lindi, Kahama, Bariadi, Bagamoyo and Kibaha district hospitals and 2 in Unguja and Pemba islands of Zanzibar. The Vision Centres created employment opportunities for 23 optometrists (existing and some new) and 3 Assistant Medical Officers (AMOs). All were employed by the Ministry of Health. A typical Vision Centre consists of a refraction unit, Optical Cut and Fit Laboratory and a Dispensing unit. The Vision Centres screen and test eyes for refractive errors, provide basic low vision services as well as spectacles to those who need and refer those who need further treatment for specialized care.
Child Eye Health
Tanzania was one of the countries that benefited from The East Africa CEH project funded by the Seeing is Believing. The project embedded the child eye health program into existing school health programs focusing on the full integration of child eye health services in the national school health policy. Under the CEH project, together with our key project implementing partners, we trained various health cadres in child eye health, low vision and paediatric refraction and equipped eye units. The project proved to be a catalyst for significant changes in the new School Health Policy and Strategic Plan in Tanzania which integrated child eye health into school health programs.
-  Eden R Mashayo* Dip Optom Ving Fai Chan* MSc BOptom Prasidh Ramson* BSc BOptom Farai Chinanayi*† BSc MPhil Kovin S Naidoo*† PhD OD *
 Ving Fai Chan,1 Fatma Omar,2 Eden Mashayo,1 Damaris Mulewa,3 Lesley Drake,3 Mary Wepo1