Abstract

BackgroundThe provision of eye care in the developing world has been constrained by the limited number of trained personnel and by professional cultures. The use of personnel with specific but limited training as members of multidisciplinary teams has become increasingly important as health systems seek to extract better value from their investments in personnel. Greater positive action is required to secure more efficient allocation of roles and resources. The supply of professional health workers is a factor of the training system, so it stands to reason that more cost-effective, flexible and available education methods are needed. This paper presents a highly flexible competencies-based multiple entry and exit training system that matches and adapts training to the prevailing population and service needs and demands, while lifting overall standards over time and highlighting the areas of potential benefit.MethodsLiterature surveys and interviews in five continents were carried out. Based on this and the author's own experience, a encies-based multiple entry and exit scheme for eye care in a developing country was derived, modeled and critically reviewed by interested parties in one country.ResultsThe scheme was shown to be highly cost-effective and readily adaptable to the anticipated eye care needs of the population. Eye care players in one selected country have commented favourably on the scheme.ConclusionThe underlying principles used to derive this model can be applied to many eye care systems in many developing countries. The model can be used in other disciplines with similar constructs to eye care.

Highlights

  • The provision of eye care in the developing world has been constrained by the limited number of trained personnel and by professional cultures

  • If a legitimate alternative to the World Health Organization (WHO) standard is used impairment prevalence will increase by 65% [3]

  • This paper proposes a public eye care system for developing countries based on a service-staffing paradigm that permits an eye care worker to move both "upwards" and "sideways", reflecting increases in the worker's repertoire of competencies within one vocational stream or crossing over from one vocational stream to another as health demands and occupational preferences change over time

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Summary

Methodology

Narrowing the gap between eye care needs and service provision: the service-training nexus.

Methods
Background
F1 E1 D2 D1 C3 C2 C1 B3 B2 B1 A3 A2 A1 Ophthalmologist
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Vision 2020
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