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Helen Chan, Andreas Mueller; Measurable Indicators of Eye Care Integration into Health Systems in the Western Pacific. Invest. Ophthalmol. Vis. Sci. 2014;55(13):6092.
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WHO’s new global action plan 2014-2019 “Towards Universal Eye Health” recommends better integration of eye health within health systems. Key measurable indicators include the number of Member States which include eye care sections in their national lists of essential medicines and include eye health into national health plans.Our purpose was to assess the current state of integration of eye care into health plans and policies in the 28 low- and middle-income Western Pacific Region (WPR) Member States.
Systematic qualitative review of key documents including: National health plans and strategic frameworks of ministries of health National minimum packages of care Essential drug and equipment lists
23 WPR states had National Health Plans accessible electronically via internet search, ministry of health and WHO databases, or through contact persons in country offices. Of these, 12 Plans (52%) made at least one reference to eye care. Only one of 23 Plans (4%) was linked to a Vision 2020 National Plan (Mongolia).3 WPR states had National Minimum Packages of Care accessible. Of these, only 1 Package (Cambodia) was inclusive of eye care, specifically the management of refractive error, active trachoma and cataract.15 National Drug Lists were available and evaluated for the inclusion of basic eye medications as per Vision 2020 Technology Guidelines (2006). Of these 15 lists, only 3 (20%) listed all four of the basic medications (Solomon Islands, Tonga & Vanuatu). No National Equipment Lists were identified from WPR states.
This study forms the first summary of currently available information on the integration of eye care into health planning in low- and middle-income WPR states. The major limitation is incompleteness of data, which highlights the need for development of a central database. Only 52% of National Health Plans made specific reference to eye care and only 4% of Plans were linked to a Vision 2020 Plan. Eye care may be better formally integrated into health systems at a national level if it is more specifically included in National Health Plans. Eye care integration into primary care may be improved if the necessary medications and equipments are available at the point of primary care provision. Assuming policies and plans have sufficient reach, one first step is to include basic eye medicines on National Essential Drug Lists.
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