This document discusses mobilizing community health workers and volunteers to identify children in need of eye care services. It notes that blindness is a public health issue best addressed at the community level. Mobilizing community workers can increase coverage, promote gender inclusivity, and reach non-school attending children. Their roles would include identifying eye disorders, referring children to eye care facilities, providing follow-up and health education. Potential benefits include increased referrals and awareness, while addressing barriers to access. The experience in India and Nepal engaging Anganwadi workers, ASHAs, and FCHVs has yielded successful identification and treatment of children with eye disorders.

1. IDENTIFYING THE LAST CHILD - MOBILISING
COMMUNITY HEALTH WORKERS / VOLUNTEERS
Manish Kumar, Orbis International 28 November 2015

2. THE NEED…
Blindness is a public health issue
and efforts should be made to tackle
it at the community level adopting
relevant strategies.
Outreach = Reach Out
│ 2│ 2
Base Hospital
work
Community
Work
(Outreach)

3. WHY MOBILIZE COMMUNITY HEALTH WORKERS?
• To increase coverage
• Promotes integration of eye health in
the overall health agenda
• Promotes gender inclusivity
• Reach out to children who do not go to
schools (pre-school age group and
school drop-outs)
• Reach out to children with multiple
disabilities
• Avenue for increasing community
ownership
• Develop a sustainable referral network
in the community │ 3

4. • ASHAs (Accredited Social Health Activists)
under the Govt. health program
• Anganwadi Workers (under the ICDS program
of Govt)
• Special Educators
• FCHVs (Female Community Health
Volunteers) in Nepal
• NGO Volunteers
• Other Volunteer Groups (Rural Medical
Practitioners, Traditional Healers, College
Students, NCC Cadets, NSS Volunteers, etc.
│ 4
WHO ARE THEY?

5. WHAT IS THEIR ROLE?
• Act as Key Informants (KI)
• Identification of ocular disorders among children and referral to
nearest eye care facility
• Support in follow up after treatment
• Dissemination of eye health education at the community level
• Become a vital link between the community and service provider
• Do not conduct screening of children as school teachers do.
│ 5

6. HOW THEY CAN BE ENGAGED?
• Recommendation letter from District
Magistrate / CMOH / CDPO / DPM (NHM &
NPCB) / Inspector of Schools at district level
– facilitates the mobilization of government
employed community level workers
• Orientation on early identification of ocular
disorders and need for quick referral to an
appropriate treatment center.
• Focus Group Discussions on community
based issues
• Involve them in celebrating World Sight Day
and such similar events related to blindness
control
• Recognition of their ongoing support │ 6

7. HOW TO TRAIN THEM?
Objective: To help them become capable of identifying visible ocular disorders and
refer them to the nearest treatment center.
Methodology:
• Emphasize on the importance of their role
• Stress upon importance of early detection and referral to the right treatment
center
• Provide basic information about the eye and blinding conditions in children
• Show appropriate pictures to help them visualize
• Provide a tool-kit if possible (containing pictures, referral slips and appropriate
IEC materials)
• Dissemination of health education
• Make them aware about incentive schemes of government with respect to
identification of children with ocular disorders │ 7

8. │ 8
Training of Community Health Workers/Volunteers

9. WHAT ARE THE POTENTIAL BENEFITS?
• Increased referral of children with ocular
disorder needing intervention
• Increased coverage of school drop-out
children and those with multiple
disabilities
• Increased awareness level in the
community through information
dissemination and education
• Addresses barrier related to gender
inclusivity, accessibility and affordability
• As service provider, gain access to
community level data
│ 9

10. WHAT IS OUR EXPERIENCE?
• Anganwadi workers mobilized by partner hospitals in Siliguri and
Aligarh have yielded good number of children who underwent
surgeries.
• Of the 370 pediatric surgeries done by a partner hospital in one year, 132 (35.7%)
resulted from referral by Anganwadi workers. Additionally more than 30,000 children
got access to eye care services through their involvement.
• Anganwadi workers were instrumental in identifying Vitamin-A
deficiency among children in the project area, which was unknown at
the project planning stage. This resulted in collaboration with
Vitamin Angels to supplement Vitamin A doses for those
communities.
• About 11,500 children received supplement Vitamin A doses
│ 10

11. OUR EXPERIENCE… CONTD.
• FCHVs are being mobilized in Nepal to reach out to non-school going
children in rural pockets.
• ASHAs were trained in Siliguri in identifying children with ocular
disorders as well as diabetic adults.
• Special Educators with support from Sarva Shiksha Abhiyan in West
Bengal have been instrumental in identifying those children from
special schools and community, who needed ophthalmic treatment.
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12. THANK YOU
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