The document discusses models for organizing and managing eye care programs to deliver services. It covers several key aspects of eye care programs including establishing national commitment to eye health, developing primary eye care, adopting appropriate technologies, training human resources, conducting epidemiological assessments, monitoring and evaluating programs, collaborating with non-governmental organizations, and using strategic management approaches. The goal is to effectively deliver cost-effective eye care services to populations in need through optimized resource use and management practices.

1. ORGANIZATION AND
MANAGEMENT OF EYE CARE
PROGRAMS – SERVICE DELIVERY
MODELS
OPTOM ASKAR.PK

2. EYE CARE GENERALITIES
• Blindness and low vision constitute a mayor public health problem world-wide
and particularly in developing countries which make up the bulk of the world
population.
• Visual disability has far reaching individual, social and economic consequences
impeding development in childhood and productivity in adulthood, with
functional and quality of life implications across the whole life spectrum.

3. • Cost effective technologies are available to prevent, control or minimize visual
impairment from most disorders.
• What is wanting is the political will and professional commitment for the delivery
and application of these technologies to populations in need.

4. POLICY GUIDELINES
• National Commitment:The promotion of eye health as part of the national health
policy is, invariably, a necessary prerequisite for a National Programme
development for the Prevention of Blindness.

5. PRIMARY EYE CARE
• Primary Eye Care ensures the provision of eye health promotion and protection,
facilitates the prevention and control of visual impairment conditions, curative
treatment and rehabilitation. It also provides the basis for striving towards equity,
community participation, intersectoral collaboration and long term sustainability
of programs

6. APPROPRIATE TECHNOLOGY
• Prevention of Blindness programs should adopt the principle of appropriate
technology in widest sense, of being based on “scientifically sound and socially
accepted methods and technologies.” This ensures that the greatest benefit
accrues to the largest number of people, within the limited resources available.
• Thus interventions for cataract blindness using active outreach screening
methods and institution based large volume surgery, maximizes efficiency and
becomes cost effective.

7. • The promotion of technology transfer to developing countries for production of
intra ocular lenses (IOLs) at low cost, has been a mayor breakthrough in applying
modern surgical techniques in cataract surgery to large sections of the
population.
• Production of low cost spectacles and the local production of medications are
further examples of application of appropriate technology, with great benefit to
those in need.

8. HUMAN RESOURCE DEVELOPMENT
• Human resources consisting of a number of categories of trained personnel
comprise a key element in national programs. While ensuring the optimal
utilization of existing personnel, policy guidelines dictate that training of
personnel should be task specific and community oriented.

9. EPIDEMIOLOGICAL ASSESSMENTS AND PRIORITY
SETTING
• Knowledge of the magnitude and causes of visual impairment in countries is an
important prerequisite for programme planning and priority setting. Cost
effective methodologies have been developed for surveys of blindness and visual
impairment and applied in member countries

10. MONITORING, EVALUATION AND QUALITY OF CARE
• These elements within national programme planning and development deserve
special mention, both in the context of eye health care delivery and also respect
of specific interventions. Evaluations would include not only output measures but
also functional and quality of life assessments including where possible appraisal
of cost effectiveness. Operational research studies constitute an important aspect
of such evaluations.

11. COLLABORATION WITH NON GOVERNMENT
ORGANIZATIONS
• International nongovernment development organizations including service
organizations are partners in the global effort to prevent and control avoidable
visual disability world-wide.
• Efforts at collaboration, cooperation and coordination at the International,
Regional and national levels should be fostered in order to optimally utilize the
collective resources of these organizations. Appropriate mechanisms could be set
up to facilitate the activities to be carried out towards achieving the common
objective of preventing blindness and visual disability.

12. PROFESSIONAL MANAGEMENT FOR EYE CARE
• Strategic management
The strategic management process starts with a clear and transparent ‘vision’
followed by situational analysis. Annual objectives are agreed upon by studying the
magnitude of blindness, unmet needs, and organisational capacity.

13. AS PART OF THE STRATEGIC PLANNING, ORGANISATIONS SHOULD
CONSIDER VERTICAL INTEGRATION WHICH BRINGS TOGETHER THE
FOLLOWING FACILITIES:
• optical shop
• clinical laboratory
• pharmacy
• Canteen
Together, these components help towards self-sufficiency of the organisation, and
convenience of the patients. In the absence of these facilities, business outlets often
exploit patients.

14. HUMAN RESOURCES MANAGEMENT (HRM)
• Today the success of any organisation is centred on its most powerful resource, its
staff.
• We must invest in the workforce which is the real pillar of an organisation.
• Personnel policy, covering human resource planning to retirement benefits, needs
to be redesigned to delight our own people.
• Only a delighted employee can delight a customer. HRM is the foundation for
quality.
• Successful organisations honour their people by recognising them as ‘service
partners’ or ‘internal customers’. Empowerment, continuous training and
development are vital parts of HRM.

15. MANAGING QUALITY
• Consumerism has entered health care. Patients represent a group of consumers
who ask relevant questions, and make their own decisions.
• They look for the right services for the right money, ask questions about
treatment options, look for more information, demand convenience, ask for
evidence of quality, expect continuity of care, and explore alternative therapies.

16. • Controlling infection, monitoring complications, length of stay, visual acuity,
follow-up rate, and safe medication are a few of the clinical quality measures that
need continuous monitoring and improvement. Productivity governed by
management systems and standard clinical protocols sharpen the clinical skills.

17. MARKETING
• The common citizen does not know where reasonable quality care is available at a
reasonable cost. As professionals are reluctant to use marketing as a powerful
information tool, many people are misguided by vested interest groups. It is
therefore important to understand how best to inform people about the services
available, so that they can make sensible judgments when seeking care.

18. COMMUNITY OUTREACH
• Outreach programmes are essential in developing countries, as people neither
have access to care nor awareness of health problems. Screening camps,
community-based rehabilitation, and school screening programmes are some of
the common approaches used.
• Planning, community participation, involvement of ophthalmologists,
standardised systems and procedures, patient counselling and review are crucial
to outreach programmes.
• Monitoring and reviewing performance and outcomes is important.

19. PATIENT COUNSELLING
• In many organisations, counselling has been one of the key contributors to
dramatic growth. Patient counselling is a simple process of educating
beneficiaries about the need and importance of eye care.
• . It builds confidence among potential patients. Counsellors assist patients in
decision-making by giving detailed information about the operation, pre-
operative care, post-operative care, discharge, and follow-up. Counselling
enhances patient satisfaction, and those satisfied patients act as catalysts to bring
more patients.

20. FINANCIAL SUSTAINABILITY
• Irrespective of the consumer's ability to pay, health care organisations face ever-
increasing costs due to rapid advancement in technology, increased expectations
of staff, etc. Health care provision is labour-intensive and staff salaries alone
constitute a major percentage of the running costs.

21. MATERIALS
• Of the total cost, materials amount to approximately 40 to 45 per cent of the
operating budget. Cost containment in this area usually brings quick results that
invariably are well accepted, unlike reduction of personnel costs.
• The purpose is to ensure control from acquisition to disposal of materials.
Purchase policy, simple inventory techniques like safety stock and re-order level,
standardisation of supplies and equipment, and consumption report correlating
to the level of activity (e.g., numberof lenses issued and number of IOL implants in
a month) help controlthe cost.

22. CONCLUSION
Professional management practices would enhance staff satisfaction, improve
quality, patient satisfaction, and public perception of services. This in turn would
generate demand which could be met by providing a low-cost service through
optimal use of the available limited resources.

23. • . Ultimately, eye care organisations will become part of VISION 2020 by ensuring
long-term sustainability.
• Are eye care organisations ready to include professionals, formally trained in
hospital management, to ensure that administrative functions are effective?