Abstract
With a global target set at reducing vision loss by 25% by the year 2019, sub-Saharan Africa with an estimated 4.8 million blind persons will require human resources for eye health (HReH) that need to be available, appropriately skilled, supported, and productive. Targets for HReH are useful for planning, monitoring, and resource mobilization, but they need to be updated and informed by evidence of effectiveness and efficiency. Supporting evidence should take into consideration (1) ever-changing disease-specific issues including the epidemiology, the complexity of diagnosis and treatment, and the technology needed for diagnosis and treatment of each condition; (2) the changing demands for vision-related services of an increasingly urbanized population; and (3) interconnected health system issues that affect productivity and quality. The existing targets for HReH and some of the existing strategies such as task shifting of cataract surgery and trichiasis surgery, as well as the scope of eye care interventions for primary eye care workers, will need to be re-evaluated and re-defined against such evidence or supported by new evidence.
Highlights
Vision loss affects approximately 223 million people globally, 32 million of whom are blind [1]; there are an estimated 4.8 million blind in sub-Saharan Africa (SSA) [2]
Considering the complexity and variety of conditions that can lead to vision loss, the paucity of tested curricula and treatment algorithms for this level, and the low numbers of patients with eye problems compared to other conditions demanding time from primary health care workers, it is unrealistic to expect much eye care to be delivered at the primary care level [46]
This paper has characterized the types of evidence that are needed to inform human resources for eye health (HReH) target setting and policy in SSA and described the limited evidence that is available
Summary
Vision loss affects approximately 223 million people globally, 32 million of whom are blind [1]; there are an estimated 4.8 million blind in sub-Saharan Africa (SSA) [2]. There are a number of reasons for the low productivity: NPCS are generally trained to do surgery on “cataract blindness” rather than on people before blindness, and NPCS have limited capacity to negotiate the necessary support (manpower, supplies, financing) required to provide the surgical services compared to physicians.
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