Factors influencing rates of retinopathy of prematurity in Argentina: A case study of policy, legislation, and international collaboration

Abstract

PurposeTo describe the processes and stakeholders, including the Ministry of Health (MOH) and UNICEF, involved in the process from the recognition of an epidemic of ROP blindness in Argentina to the development of national guidelines, policies and legislation for its control.MethodsData on the incidence of ROP was collected from 13 NICUS from 1999 until 2012, as well as the percent of children blind from ROP in 9 blind schools throughout 7 provinces in Argentina. Additionally, document reviews, focus group discussions and key informant interviews were conducted with neonatologists, ophthalmologists, neonatal nurses, MOH officials, clinical societies, legislators and UNICEF staff in the 7 provinces.ResultsIn the late 1990’s over 80% of children under 5 years old in schools for the blind were blind from ROP. Recognition of this led to the formation of a National ROP group through the MOH in 2003, a targeted intervention of workshops and capacity building with UNICEF from 2004 to 2008 and the development of a national ROP screening law in 2007. By 2012, the rates of ROP as a cause of blindness in children in blind schools and the rates of severe ROP needing treatment in the NICUs visited had decreased significantly.DiscussionThe combination of a national ROP program, collaboration with UNICEF and national legislation, played a role in decreasing ROP in 7 provinces throughout Argentina.ConclusionsThe lessons learned and successes experienced in Argentina can hopefully be replicated in other countries in Latin America and beyond. PurposeTo describe the processes and stakeholders, including the Ministry of Health (MOH) and UNICEF, involved in the process from the recognition of an epidemic of ROP blindness in Argentina to the development of national guidelines, policies and legislation for its control. To describe the processes and stakeholders, including the Ministry of Health (MOH) and UNICEF, involved in the process from the recognition of an epidemic of ROP blindness in Argentina to the development of national guidelines, policies and legislation for its control. MethodsData on the incidence of ROP was collected from 13 NICUS from 1999 until 2012, as well as the percent of children blind from ROP in 9 blind schools throughout 7 provinces in Argentina. Additionally, document reviews, focus group discussions and key informant interviews were conducted with neonatologists, ophthalmologists, neonatal nurses, MOH officials, clinical societies, legislators and UNICEF staff in the 7 provinces. Data on the incidence of ROP was collected from 13 NICUS from 1999 until 2012, as well as the percent of children blind from ROP in 9 blind schools throughout 7 provinces in Argentina. Additionally, document reviews, focus group discussions and key informant interviews were conducted with neonatologists, ophthalmologists, neonatal nurses, MOH officials, clinical societies, legislators and UNICEF staff in the 7 provinces. ResultsIn the late 1990’s over 80% of children under 5 years old in schools for the blind were blind from ROP. Recognition of this led to the formation of a National ROP group through the MOH in 2003, a targeted intervention of workshops and capacity building with UNICEF from 2004 to 2008 and the development of a national ROP screening law in 2007. By 2012, the rates of ROP as a cause of blindness in children in blind schools and the rates of severe ROP needing treatment in the NICUs visited had decreased significantly. In the late 1990’s over 80% of children under 5 years old in schools for the blind were blind from ROP. Recognition of this led to the formation of a National ROP group through the MOH in 2003, a targeted intervention of workshops and capacity building with UNICEF from 2004 to 2008 and the development of a national ROP screening law in 2007. By 2012, the rates of ROP as a cause of blindness in children in blind schools and the rates of severe ROP needing treatment in the NICUs visited had decreased significantly. DiscussionThe combination of a national ROP program, collaboration with UNICEF and national legislation, played a role in decreasing ROP in 7 provinces throughout Argentina. The combination of a national ROP program, collaboration with UNICEF and national legislation, played a role in decreasing ROP in 7 provinces throughout Argentina. ConclusionsThe lessons learned and successes experienced in Argentina can hopefully be replicated in other countries in Latin America and beyond. The lessons learned and successes experienced in Argentina can hopefully be replicated in other countries in Latin America and beyond.