June 2023
Volume 64, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2023
A Public Private Partnership Model for Integrating Services for Prevention, Screening and Management of Retinopathy of Prematurity
Author Affiliations & Notes
  • Vishal Govindahari
    Pushpagiri Vitreo Retina Institute, Secunderabad, India
  • Murthy GVS
    Indian Institute of Public Health Hyderabad, Hyderabad, India
  • Bala Vidyadhar MS
    Pushpagiri Vitreo Retina Institute, Secunderabad, India
  • Rajan Shukla
    Indian Institute of Public Health Hyderabad, Hyderabad, India
  • Sai Kiranmayee P
    Pushpagiri Vitreo Retina Institute, Secunderabad, India
  • Footnotes
    Commercial Relationships   Vishal Govindahari None; Murthy GVS None; Bala Vidyadhar MS None; Rajan Shukla None; Sai Kiranmayee P None
  • Footnotes
    Support  USAID Childhood Blindness Program - CBP023
Investigative Ophthalmology & Visual Science June 2023, Vol.64, 1420. doi:
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      Vishal Govindahari, Murthy GVS, Bala Vidyadhar MS, Rajan Shukla, Sai Kiranmayee P; A Public Private Partnership Model for Integrating Services for Prevention, Screening and Management of Retinopathy of Prematurity. Invest. Ophthalmol. Vis. Sci. 2023;64(8):1420.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : The study focused on increasing awareness among the parents and health professionals regarding risk of retinopathy of prematurity(ROP), improving quality of care for preterm infants, ensuring early disease identification by timely screening, treatment and long-term follow-up of detected babies with ROP. The study was performed in five districts of South India.

Methods :
1) Improving quality of preterm care using training workshops at special new born care units(SNCU) aimed at capacity building with regards to risk factor and high-risk baby identification.

2) Sensitization of grassroot health workers (250 workers at village levels, 25 meets) ) to increase awareness about ROP. These health workers educate mothers about risk factors and need for ROP screening during antenatal visits.

3) SNCU nurses were trained in ROP imaging using wide-angle fundus camera, basic interpretation and counselling.The SNCU database was used to identify all eligible babies based on national ROP guidelines . A grading hub was established at the base hospital to provide image interpretation and management decision by a trained retinal specialist to facilitate near real time reporting.

4)The base hospital treated ROP based on recommendations of Early Treatment of Retinopathy of Prematurity (ETROP) study and national operational guidelines for prevention of blindness from ROP in India.

5) Long-term follow-up and low vision care for preterm infants was planned at District Early Intervention Centers (DEICs) by the incumbent optometrists which was supported initial low-vision training followed by monthly handholding sessions.

Results : Screening centers for ROP: Nine SNCUs ( five tertiary and four secondary care) in Southern India
Total number of babies screened: 3749 in 13 months
70-75% of eligible babies screened
75 babies (2-3% of screened) required treatment
Around 30 babies (~40%) of babies treated with combination of injections followed by laser

Conclusions : The study succintly demonstrated that with targetted upskilling, quality improvement and appropriate handholding, the existing health care machinery can be used to effectively prevent and manage a complex and skill-intensive condition such as ROP. The studies aspires to serve as a blue print in democraitising health care delivery using simple and efficacious interventions.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.

 

Nurses at SNCUs screening for ROP using a fundus camera under guidance

Nurses at SNCUs screening for ROP using a fundus camera under guidance

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