Abstract
BackgroundThis study measured the effectiveness and cost of a capacity building intervention in 25 eye hospitals in South Asia, East Africa and Latin America over 4 years. The intervention involved eye care non-governmental organizations or high-performing eye hospitals acting as “mentors” to underperforming eye hospitals- “mentees” in 10 countries. Intervention activities included systematic planning and support for training and key equipment purchases as well as hospital-specific mentoring which focused on strengthening leadership, increasing the volume and equity of community outreach, improving surgical quality and volume, strengthening organizational and financial management and streamlining operational processes.MethodsThis is a before and after observational study of the impact of this multi-dimensional process on hospital and individual productivity and financial sustainability after 4 years. Mentee hospitals reported data monthly using a standardized template. Key indicators included cataract surgery volume, cataract operations per surgeon, the proportion of direct paying cataract surgical patients, intervention program costs per additional surgery and cost per mentor.ResultsBy the end of the study period, the hospitals experienced a 69% average increase (range: −63% to 690%) in cataract surgical volume over baseline with 12 hospitals showing increases over 100%. Twenty-three hospitals experienced a 59% average increase in the number of cataract surgeries per surgeon with 10 hospitals showing increases over 100%. The proportion of paying patients increased in 8 of the 14 hospitals reporting this data. The average mentoring cost per additional surgery for these 25 hospitals was $5.39. An average of $36,489.99 was spent per mentor per year to support their work with mentees.ConclusionsThe intervention resulted in proportionally similar increases in cataract surgical volume and productivity across diverse settings in three distinct geographic regions. Its wide applicability and moderate cost make it an attractive means to rapidly and substantially increase eye care services to meet VISION2020 goals.
Highlights
This study measured the effectiveness and cost of a capacity building intervention in 25 eye hospitals in South Asia, East Africa and Latin America over 4 years
Using the increased volume and high quality approaches initially developed by Aravind Eye Care System (AECS) and LV Prasad Eye Institute (LVPEI) in India, ophthalmologists, along with a wellmanaged team, can double or triple their cataract surgical volume [2]
For this research we had three primary questions: 1. Did the capacity building intervention result in an increase in the number of cataract surgical operations per year?
Summary
This study measured the effectiveness and cost of a capacity building intervention in 25 eye hospitals in South Asia, East Africa and Latin America over 4 years. Intervention activities included systematic planning and support for training and key equipment purchases as well as hospital-specific mentoring which focused on strengthening leadership, increasing the volume and equity of community outreach, improving surgical quality and volume, strengthening organizational and financial management and streamlining operational processes. Using the increased volume and high quality approaches initially developed by Aravind Eye Care System (AECS) and LV Prasad Eye Institute (LVPEI) in India, ophthalmologists, along with a wellmanaged team, can double or triple their cataract surgical volume [2]. Judson et al BMC Ophthalmology (2017) 17:96 has no financial connection It is a structured, planned and often altruistic effort to help other institutions wishing to grow and improve productivity and efficiency. Capacity building is distinct from capacity ‘development’ which is an internal process not involving explicit external involvement [5]
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