primary eye care and community participation dr. saman wimalasundera mbbs, do, phd senior lecturer...
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Primary Eye Care and Community Participation
Dr. Saman Wimalasundera MBBS, DO, PhD
Senior lecturer in community medicine
& community ophthalmologist
Community Ophthalmology center
Department of community medicine
P.O.Box 70,
Galle
Sri Lanka
Primary eye care and community participation
Delivery of primary eye care has its specific roles and targets in the community and good community participation is an essential component in the successful prevention of blindness program.
Primary eye care is the primary health care approach to the prevention of blindness.
Essential components of primary eye care
1. Promotive
2. Preventive
3. Curative
4. Rehabilitative
(1) Promotive eye care
1.Creating and awareness of the blinding diseases existing in the community and the ways of preventing or curing it.
2.How to use the available recourses to overcome the problems.
(2) Preventive eye care
1.Motivation of individuals and their
communities to participate in blindness
prevention activities.
2.Social and community development that promotes health
3.Change of behavior and environment
Examples
Provision of adequate safe water.
construction of latrines &refuse pitsmaintenance of environmental
hygiene.Consumption of food rich in vitamin A. Care for individuals at risk.
Prevention of measles, malnutrition and
diarrhea in children
Protection of eyes against injuries.
Immunization (E.g. Measles)
Screening of antenatal mothers for sexually
transmitted diseases.
Family planning
(3) Curative activities
1. To carry out treatment procedures for simple common diseases that lead to blindness or impaired vision if not treated
e.g. corneal ulcers, refractive errors etc.2. First aid treatment for eye injuries. 3.Timely referral to secondary level.4.Identification of potentially blinding disease conditions for proper management5.Identification of curable blinding diseases e.g.cataract and referral for treatment
(4) Rehabilitative activities
Target group: Incurably blind people
What can the primary eye care workers
do to them ?
They should be assured that they are not
completely useless
Some carefully selected appropriate training should be given to them to acquire some skills
Make them functional and do not allow to depend on the others totally.
Development of primary eye care program
A good primary Eye care Program will depend on :
(1) existing health care services and availability of trained health care workers (Manpower)
(2) Political and professional motivation
(3) Resources for training, to conduct programs and to monitor it.
(4) Supplies for primary eye care workers.
(5) Funding for capital and recurrent expenditure.
(6) Close liaison with secondary and tertiary centers
(7) Careful Planning and evaluation
Basic equipment essential for PEC program
• Snellens chart and pinhole
• Hand magnifying lens
• Good source of light (Torch with batteries)
• Eye dressings
• Teaching materials
Different Types of Primary Eye care Programs that can be used in the
community• Depend on the need of the local community
and available resources
1. Need assessment Programs
2. Screening for blinding diseases
3. Comprehensive care Eye camps
4. Out reach Surgical Camps
5. Health Education Programs
Sustainability of the PEC programs
Depend on the following areas
1. Technical sustainability :- Training of technical staff
2. Financial sustainability :- Continuous allocation of funds
necessary
3. Operational sustainability :- Monitoring of the activities regularly.
Community Participation
Ottawa charter and health promotion
In 1986 an international conference
called Ottawa charter adopts five principal
elements that improve health promotion.
The Five principals are
1. Healthy public policy2. Personnel skills development3. Community participation4. Healthy and supportive environment5. Re-organization of health services
Community participation is a major emphasis in eye health promotion.
The promotion of eye health and to
reduce the risk of blindness though
community ophthalmology needs good
community participation
Community participation is influenced by
1. Community beliefs and perceptions
2. Motivation of people in the community
3. Awareness of the problems related to blindness
Community participation can be improved by
1. Encouraging the people with early symptoms by their families to attend to available health services
2. By creating and awareness through health education programs
- Mass media programs- Through volunteers or community
health workers by small group discussions
- Through community leaders- Self help groups- Improving education of children
through schools
Community participation enhances eye health
1. By attending to the community health programs for early detection
2. By following treatment procedures until full recovery
3. By adopting changes in life style that encourages eye health
4. By improving the living environment in the communities to reduce the risk of transmission of eye diseases
5. By creating a community demand by the people of the community to develop infra structure facilities by policy makers that improves eye care services.
There is a high demand for a
community based approach in the
prevention of blindness. That needs
proper community participation.