Transcript Dr Hannah Faal_ PEC 2020 and Beyond

IAPB 9 GA
Primary eye care
2020 & beyond
Hannah Faal
© Sightsavers
Summary







Trends
Demography transition
Population transition
Epidemiological transition
Population development phases and stages
Extent of primary care
The meeting point
© Sightsavers
Trends
1978
Primary health care
1999
Vision 2020: The Right to Sight
2007
The PEC working group formation
2008
PHC: Now more than ever 2008, the reforms
2012
Universal health coverage: health as a right
Change over time ?
VISION 2020, any level of sight as a right
VISION 2020: elimination of avoidable blindness.
elimination of avoidable visual disability
© Sightsavers
Demography transition
Globally –
 an ageing
population
 survival of the
premature
Primary eye care for the two extremes: aged and ageing
and the premature
© Sightsavers
Population transition
 Urbanisation
Rural PEC
Urban PEC suited to the urban structure
• Rapid pace of change
• Urban poverty
• Lack of the traditional supportive network
 Increasing engagement with social determinants of health
© Sightsavers
Epidemiological transition
Elimination of
communicable
causes of visual loss
Primary care and
ocular morbidityincreasing awareness
Eye NCDs:
cataract, RE,
presbyopia,
glaucoma,
ARMD etc
Non – Eye
NCDs:
Diabetes
The urgency and benefits of integrated programmes and a
holistic approach
© Sightsavers
Population development phases
and stages
The people/population functions as stewards, consumers,
providers, financers of health
Their performance and needs in each phase and stage of the
population’s development
ceh_11_25_004_f01
e.g: Health promotion: adaptation and changes in content
and strategy to match
© Sightsavers
Population development phases
and stages
Into every home takes on a different meaning in each phase
and stage
• rural area by health worker, use of a poster
• The TV
• The mobile phone
• The internet
 Customisation of PEC to suit function and phase/stage.
© Sightsavers
Extent of primary care
• With increasing development and awareness of a
population on the one hand
• With the increase in life time diseases and chronicity
 Eye health in primary care will need to adapt and
integrate with these changes
• What is offered: the extent of care
• Who offers it: Task shifting/sharing
• Self care: self check for diseases
• Nature of function of front line health facilities: e.g.
screening, maintenance management of chronic diseases.
© Sightsavers
The meeting point
Primary care is the coalescing point of the interaction of health
and every other business:
• Social determinants
• All institutions, organisations whose primary intent is not
health but whose decisions, actions impact on health
• All institutions, organisations whose primary intent is
health– health systems
Today, Eye health knows eye health business
Eye health needs to know every other business
Primary care is where eye health is made everybody’s business.
© Sightsavers
Now to 2020 and beyond.