The WHO Global Action Plan 2014-2019 recognizes the importance of governments and their partners to invest in reducing avoidable visual impairment and recommends integration of eye care services in the wider health services and systems for sustainability.
Operation Eyesight has forged a partnership with the Ministry of Health in Kenya and supports implementation of the Kenya National Prevention of Blindness Strategic Plan. The plan is oriented towards provision of quality eye care services to all Kenyans, including the vulnerable members of the community. We work closely with the Ministry of Health through the Ophthalmic Services Unit and the County Departments of Health of seven counties. We also engage with the County Departments of Education and Water where we have school screening and trachoma programs respectively. We recognize the importance of partnering with government in reaching a wider coverage in addition to project buy-in, ownership and support. Furthermore, partnership with government ensures integration of primary eye care into primary health care and continuity of eye care services after the project cycle.
We team up with other stakeholders to influence and develop policies at the national level. Through a collaborative approach, we have contributed to the development of the National Prevention of Blindness Strategic Plan as well as development and ratification of eye care guidelines and policies.
County governments are responsible for the health services in their areas. Operation Eyesight signs MOUs, with County Departments of Health, that define programs’ shared goals, objectives, expectations and roles and responsibilities of each partner. While the role of the County Departments of Health is to manage health services in the county, the eye units’ sole responsibility is to provide clinical eye care services. Operation Eyesight provides grant, technical and program management expertise, including community eye health
County Departments of Health and eye unit teams are engaged from project identification and definition to cultivate project ownership and buy-in. Jointly with the partners, Operation Eyesight identifies gaps in the health system and plans the best way to narrow the gap within the context of competing needs and available resources. For instance, OE has, in the past, identified gaps in human resources for eye health and worked with County Departments of Health to identify staff and support them for specialized training in ophthalmology. Upon completion of training, these personnel are deployed to serve in the eye units. Other gaps we have identified jointly include inadequate infrastructure; inadequate supply of essential medicines and consumables and inadequate diagnostic and theater equipment.
Beside training of human resources for eye health, OE’s support comes in form of donations of consumables, ophthalmic equipment and construction and renovation of eye units. We require that donated equipment is entered into the hospital’s asset inventory. Henceforth, the hospital is responsible for the security and maintenance of the equipment. Further, the County Departments of Health provide space where eye units are constructed or provide space to renovate and created eye unit infrastructure.
Our community eye health project entails training Community Health Volunteer (CHVs), a cadre recognized by the health system and responsible for prevention and promotion of health at level one of the health pyramid. Our eye health programs recognize the critical role CHVs play, and we support their training in primary eye care to conduct door to door screening, identify eye conditions, provide counselling to patients and refer them to the nearest eye units.
For school screening programs, we work with the ministries of Health and Education through their established structures, which include County Departments of Education Resource Centers, Teachers Services Commission, Head teachers and School Health Patrons.
However, working with government has its own challenges; lack of prioritization of eye health resulting to limited allocation of resources, a challenge we have been struggling with over the years. Our advocacy is slowly bearing some fruits. Just recently, eye health is featuring in County Development Plans which is a huge step for consideration in allocation of resources. Frequent change of leadership at the county at times means delay in project implementation due to delay in decision making process.
Weak supply chain and limited resources often result in erratic supplies. To mitigate this, part of our support includes ensuring county procurement department is informed of essential drugs list and suppliers whose prices are affordable. Another challenge is high service delivery costs, pushed up by staff allowances for working away from their stations during outreaches. Operation Eyesight together with other Eye Care INGOs in Kenya and the Ophthalmic Services Unit agreed on some reasonable rates payable to ophthalmic workers to cater for their accommodation and meals when working away from their stations.
In conclusion, despite a myriad of challenges experienced partnering with government, the benefits of project sustainability override the challenges.