Uganda has a scarcity of trained eye care professionals available to provide accessible eye care and this directly contributes to disadvantaged lives. We have been working to impact change for nearly 10 years including extensive child eye health, community eye health, education and optometry development programs.
In Uganda, we have worked in partnership with the government and other key organisations since 2008 to improve access to eye care. The focus has been on supporting sustainable interventions, such as the National Intervention on Uncorrected Refractive Errors aimed to improve service delivery and increase access to affordable eye care services; and the current National Eye Care Plan which recognises the need to better serve blind and severe vision impairment, and improve service delivery to the population by up-skilling existing eye health human resources.
Over the last decade we have collaborated closely with the ministries of health and education at all levels, accessing existing health infrastructure and staff thereby ensuring additional services align with local ownership and are moving towards sustainability. The increased eye care services in Uganda support screening children through the schools screening program and adults through community outreach.
These expanded services are reaching increased numbers of children and adults with vision problems through the initial screening, followed on by referral to the nearest established eye health facility ensuring access to further care, surgery or medication.
Equally our emphasis has also focused on the development of optometry as a government supported profession within the tertiary education system. Consistent advocacy has influenced government support for optometry through policy change to increase allocation of optometry positions within the existing public health services by making these permanent positions available to graduate optometrists.
East Africa Child Eye Health Program
Left untreated in childhood vision impairment can have long-lasting consequences including learning difficulties, reduced educational outcomes and employment opportunities. Focused, child eye health programs, integrated into existing health services with active health promotion, can have the biggest impact on the vision of children. They help break down barriers to services and introduce healthy habits that can last a lifetime.
Launched in 2012 and concluding in 2016, the East Africa Child Eye Health program, funded by Standard Chartered Bank under the Seeing is Believing program, worked specifically to improve the quality of lives of children aged 0-15 years. The collaborative program increased delivery of eye care services and the amount of eye care workforce, guided new infrastructure and strengthening existing health referral linkages.
The program ran in targeted districts in three countries; Kenya, Tanzania and Uganda, with child screening figures achieving more than twice the targets totalling 4,624,256 collectively. In Uganda alone the figure of children screened equalled 1,672,945. Many of these children received spectacles, low vision devices, treatment or referrals for further care where necessary.
The program aimed to improve the quality of eye health services and access for all children aged 0-15 years. The School Eye Health Program was established as a sustainable and efficient model of delivering eye health services to children. This was significant stride towards improving the quality of early intervention and education of children with vision impairment by ensuring that the children receive necessary specialised educational support. The program was also involved in the evaluation of model approaches for promoting child eye health in East Africa, documenting and publishing these findings to inform future strategies and replication with the ultimate goal of embedding Child Eye Health in the policies and program work of the Ministries of Health and Education.
We support focused eye health programs in areas of underserved need guided by the aim of achieving equity in access to eye care for all people.
The Mubende Comprehensive Eye Care program is working to increase eye health for the adult and child population of four disadvantaged districts in the Mubende health region. Extensive outreach screenings provided on regular rotation and the development of eye care infrastructure to support the raised level of services needed to accommodate the increased levels of presenting patients, has all worked towards the same point of elevating eye care received. Aided by health promotion targeting villages and schools, thousands of people have already been reached who had not previously had access to or received eye care.
Optometry has the capacity to change the eye care landscape of Uganda by providing the trained workforce to build an integrated, comprehensive approach to eye health. This profession is very young, emerging over the last three years since we supported the opening of the optometry program at Makerere University, Kampala in 2014. Currently there are optometry students enrolled in years one, two and three of the optometry program at Makerere University, the first graduates will emerge in 2018.
An Academic Vision Centre was opened on the Makerere University campus in 2016 providing both a practical training facility for the optometry students and a much-needed eye care service to the community. In addition to walk-in patients, the Academic Vision Centre has the capacity to provide community outreach projects to remote locations. This potential for broad reaching public advocacy work over time will generate further service uptake through the door of the vision centre effectively completing the service provision cycle.