Eye care program management: Efficient models ensure accessibility, quality, and sustainability, promoting community engagement and optimal vision health.

1. Organisation and
Management of Eye
Care Programme
Service Delivery
Models
Presented by:
Harsh Rastogi
PhD Student
Advanced Eye Centre

2. Introduction
• National Program for Control of
Blindness, 1976:
• Goal: Reduce blindness
prevalence from 1.4% to 0.3%
by 2020.
• Focus primarily on cataract-
related blindness.
• Success story:
• Decrease in cataract
prevalence.
• Increased cataract surgical
rate (CSR).
• Definition change to National
Program for Control of
Blindness & Visual Impairment,
2017:
• Aim: Address overestimation
of blindness in India due to
differences in criteria.
• New goals:
• Expand focus to include
other causes of visual
impairment such as diabetic
retinopathy, glaucoma,
childhood blindness, low
vision, and cataract.

3. Importance of Eye Care
Programs
2.2 billion people worldwide have a vision
impairment or blindness, with the majority being
preventable or treatable.
253 million people are visually impaired, of which
36 million are blind.
Untreated eye conditions can lead to decreased
productivity, increased healthcare costs, and
reduced quality of life.

4. Objectives of Eye Care
Programs
Prevent eye diseases through public health interventions and health
education.
Prevent
Provide treatment for existing eye conditions, including surgeries,
medications, and corrective lenses.
Treatment
Offer rehabilitation services to enhance the quality of life for
individuals with visual impairment.
Rehabilitation
Promote eye health education and awareness.
Aware

5. Indian Community Health System
Super-
Speciality
Centre, Medical
College
District Hospital
(DH)
Community Health Centre (CHC)
Primary Health Centre (PHC)
Sub-Centre (SC); Health and Wellness Centre (HWC)
Community Level
*Ophthalmologist and
Ophthalmic Assistant, OTA
Specialist, Nurse and other
staff= 105-393
*Ophthalmologist and
Ophthalmic Assistant
Specialist, Nurse and Other
Staff = 46
*Ophthalmic Assistant
Medical Officer, nurse and other staff
=13
1 CHO, 2 MPW, 1 ANM
ASHA workers
Variable
District Population
80000-120000
30000-50000
3000-5000
1 ASHA/1000

6. Service Delivery & Referral
Network

7. Service Delivery Models
Overview
Hospital-Based, Community-
Based, Integrated Health
Systems, Telemedicine and
e-Health, Public-Private
Partnerships, and NGO-
Driven Models.
The selection of a service
delivery model should
consider population
density, geographic
location, infrastructure,
and resources.

8. Hospital-Based Models
Hospital-based models involve specialized eye hospitals or
eye care units within general hospitals that offer a wide
range of diagnostic, treatment, and surgical services.
These facilities require advanced equipment and skilled
ophthalmologists, optometrists, nurses, and support staff.
Advantages include access to specialized treatments,
surgical facilities, and multidisciplinary care teams.

9. Community-Based Models
• Community-based models bring
eye care services directly
to communities through
mobile clinics, outreach
programs, and community
health workers.
• These models can overcome
geographical, financial, and
cultural barriers, leading
to improved access, uptake,
and outcomes.

10. Integrated Health
Systems
• Integrated health systems
involve incorporating eye care
services into existing
healthcare infrastructure,
such as primary care clinics,
health centres, and hospitals.
• This approach improves
accessibility, continuity of
care, and cost-effectiveness.

11. Telemedicine and
E-Health
• Telemedicine enables remote
diagnosis, consultation, and
monitoring of eye conditions
using telecommunications
technology.
• This approach can overcome
geographical barriers,
increase access to
specialist care, and improve
patient outcomes.

12. Public-Private
Partnerships
(PPPs)
• PPPs involve collaboration
between government agencies,
private sector companies, and
non-profit organizations to
deliver eye care services and
address public health
challenges.
• PPPs can harness the
strengths and expertise of
multiple stakeholders,
enhance service delivery
capacity, and achieve greater
impact.

13. NGO-Driven
Models
• NGO-driven models
involve non-
governmental
organizations taking
the lead in planning,
implementing, and
managing eye care
programs.
• These models are
flexible, innovative,
and community-engaged,
leading to sustainable
and culturally

14. Human Resource Management
• Human resources are the
backbone of eye care
delivery, encompassing a
diverse range of
professionals, including
ophthalmologists,
optometrists, nurses,
and community health
workers.
• Strategies for
recruiting, training,
and retaining qualified
eye care professionals
are essential for
effective eye care
delivery.

15. Training and Capacity Building
Continuous learning is essential to keep pace
with advancements in eye care, improve clinical
skills, and enhance the quality of patient
care.
Universities, colleges, and training centres
offer formal education and training programs
for aspiring eye care professionals.

16. Infrastructure
and Equipment
Infrastructure refers to
the physical facilities
and resources needed to
provide eye care
services, including
clinics, hospitals,
operating rooms, and
diagnostic laboratories.
Essential equipment for
eye care services
includes diagnostic
instruments, surgical
tools, laser devices, and
vision testing equipment.

17. Financing
Mechanisms
• Financing refers to the
mechanisms used to fund
the delivery of eye care
services, including
government funding,
insurance schemes, user
fees, philanthropy, and
donor support.
• Sustainable financing
models are essential to
ensure the availability,
accessibility, and
affordability of eye
care services over time.

18. Monitoring and Evaluation
Monitoring and evaluation involve systematic
tracking and assessment of program performance,
outcomes, and impact to inform decision-making
and improve program effectiveness.
Key indicators for measuring program
performance include access, quality, and
patient outcomes.

19. Challenges and Solutions
Challenges:
• Limited resources
• infrastructure
constraints
• workforce shortages
• accessibility barriers
Solutions:
• Include advocacy
efforts to mobilize
resources
• Partnerships to
leverage strengths and
expertise
• Technology adoption to
improve efficiency
• Community engagement
to address local needs
and preferences

20. Comprehensive Primary Eye Care
(HWC)
CPEC
Health
Information
System
Human
Resource
Health
Financing
Medicine
and
Technology
Service
Delivery
Governance

21. Comprehensive Primary Eye Care
(cont.)
Eye Health Assessment Tool
(EHSA) domains
Specific provisions for eye care under Ayushman Bharat
Governance Health and Wellness Centre (HWC) linked to nearest Primary Health Centre (PHC)
Medical Officer at PHC in charge of linked HWC
Health Financing Pradhan Mantri Jan Arogya Yojana (PM-JAY) insurance scheme
Provision to cover 42 eye care packages for surgeries at tertiary centers
Health information system Data recording formats available at HWC
This information is then uploaded into (HWC) online portal
Human resource Community health officer at (HWC) is responsible for carrying out all the general and eye related
activities
Medicine & Technology Eye care specific medicines available at health and wellness centers and higher centers according
to National List of Essential Medicines (NLEM)
Telemedicine platform to create hub (specialist center) and spoke (HWC’s) model to expand eye care
services to the rural population
Service delivery Refer to slide 6

22. Best Practices
Best practices include:
• Standardized protocols
• Quality assurance
measures
• Patient centred
approaches
Implementing best
practices can:
• Improve efficiency
• Effectiveness
• Equity in eye care
services

23. Future Directions
Emerging trends include technology integration,
innovation in service delivery models, and
alignment with Sustainable Development Goals
(SDGs).
Continued research, collaboration, and
adaptation are essential to meet evolving needs
and challenges in eye care.

24. Conclusion
• Effective organization and management are
crucial for the success of eye care programs.
• By adopting evidence-based approaches,
leveraging partnerships, and prioritizing
patient-centred care, eye care programs can
improve access, quality, and outcomes for
individuals and communities.

25. Thank You!