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Dedicated to “the promotion of peacethrough the prevention of blindness”

Regional Capacity Building WorkshopProgram Design for Pediatric Eye Care

Interventions

The A2Z Child Blindness ProgramInternational Eye Foundation

Kilimanjaro Centre for Community Ophthalmology

April 7-8, 2011Moshi, Tanzania

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IEF Founded in 196149 Years Improving Ophthalmology

“If you restore the sight of one man, you benefit one man. If you teach one man how to

restore sight, you benefit many men. And if you teach many men, you benefit mankind.”

John Harry King, Jr., MD, Corneal Transplant Pioneer, IEF Founder - 1961

Global causes of Blindness 1982

ONCHO 0.52%

XEROPH 0.52%

GLAUCOMA 310%

TRACHOMA 620%

OTHERS 310%

CATARACT 1756%

37th World Health Assembly, 1982

In millions

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Milestones 1960’s to 1980‘s1960’s: Short & long-term volunteers to newly independent developing countries with no ophthalmologists of their own.Photo: Dr. Randolph Whitfield, 1972-present MacArthur Foundation Fellow 1982

1970’s: • Established paramedical ophthalmic training programs to

help build national eye care services• Provided scholarships for ophthalmologists from

developing countriesPhoto: Ophthalmic Medical Assistant Training Program, Ethiopia

1980’s:• Focus on disease programs:

trachoma, VAD, onchocerciasis• IEF is first eye care NGO

accepted into “official relations” with WHO (1985)

Trachoma

Onchocerciasis “river blindness”

Vitamin A Deficiency/Child Survival

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1990’s IEF’s Paradigm Shift to Sustainability Programming

Public health causes of blindness reduced thanks to magic bullet medicines

Emerging causes of blindness only treated by ophthalmologists

Need sustainable systems, technology, and business approach

WHO data supports needed shift – next slide

Global causes of Blindness 2004

CATARACT47%

TRACHOMA4%

ONCHO1%

AMD9%

GLAUCOMA12%

OTHERS13%

CORNEAL OPACITY5%

DIABETIC RETINOPATHY

5%

CHILDHOOD BLINDNESS.

4%

Best correctedBest correctedVisual AcuityVisual Acuity< 3/60 (0.05)< 3/60 (0.05)

New WHO data December 2004 - success against public health causes of blindness

1990’sManagement & Sustainability

What’s wrong with the system?

Unproductive? Few operations? Quality less than optimal? Old, broken and inappropriate equipment? Lack of consumables? No incentives? Qualified staff leave? Patients do not seek government eye care even if it’s free? All patients cannot access private eye care?

1990’sManagement & Sustainability

Programmatic questions:

What percent can afford private eye clinics? Where do middle income people go who can

pay a fee or have insurance, but cannot afford private clinics?

Can eye clinics serve all economic levels of society and remain financially sustainable?

IEF SightReach® Management Program Social Enterprise Approach

IEF developed a hybrid-entrepreneurial approach to eye care delivery combining best of modern clinical eye care practices business planning and management systems

Private clinics see paying patients and subsidize poor patients

Public hospitals treat the poor and have facilities for private patients who pay a fee

Sliding scale pricing structure Revenue generating services

SightReach® Management

Improve quality Use paramedicals 4/1

Outreach Earn revenue

21st CenturyTechnology

As ophthalmology has evolved, IEF has evolved from a voluntary organization to one that builds systems capacity focusing on quality, efficiency, financial sustainability and

customer satisfaction.

Ophthalmic Clinical Officer performs ICCE

Dr. Gerald Msukwa performs ECCE with IOL, Small Incision Cataract Surgery and Phaco-emulsification