Mandatory vision and ear checkup of school students in Nepal

The government of Nepal has announced a new policy that states at the beginning of each academic year, an intervention, that makes basic health including eye and ear checkup mandatory, will be implemented in schools. This is a huge step as hearing and sight are two of the five senses, one that affects education and future. Periodic vision and hearing screening is recognized as an integral part of preventive pediatric health care. Adverse effects on educational and social development are obvious consequences of poor visual and hearing acuity.

Prevalence in Nepal

The World Health Organization (WHO) estimates that 15 million children worldwide suffer from uncorrected refractive disorders and another 275 million people have compromised hearing. In Nepal also uncorrected refractive error (URE) is a public health problem. The most recent study on URE in children was published in 2011 (‘Refractive error among schoolchildren in Jhapa, Nepal’ – Journal of Optometry, April 2011). It concluded that the prevalence of URE was 8.6% and that myopia (near-sightedness or blurred distance vision, leading to difficulties in reading the blackboard) was the most common problem.

The prevalence of hearing impairment which is a common problem in school aged children in Nepal has been estimated to be 5.73%.  55.5% of the hearing loss in children in Nepal is due to avoidable causes like ear infection. With the main cause of hearing loss attributed to preventable conditions such as chronic otitis media, it is believed that early standardized screening, detection and timely management of chronic otitis media in these children can prevent hearing loss and its impact on their educational, social and language development.

The issue of access

There is an extensive network of eye facilities for refraction services In Nepal. However, there are no eye care facilities below the district-headquarter level integrated into the government health Care System. The services of an ENT are also not accessible to all. Many children have no access to basic ear care examination.

There are lot of barriers like lack of awareness, poor compliance, negligence, access to uptake of services. It is advised that children should receive both a hearing test and a vision test between the age of 2 and 2 1/2 years old. In Nepal, this is not part of the country primary health care system. As a result, many children at the community level have compromised sight or hearing.

Thus, the government of Nepal’s new next policy and programme which states that Health awareness in all the school will be enhanced by following the ‘one school-one health worker’ is a timely. This school-based eye and ear health programmes will be a useful community-oriented solution for prevention of blindness and deafness. Early detection and addressing uncorrected refractive error and hearing problems will help Nepal achieve the Sustainable Development Goals.

Image on top: Students with glasses/ Ranjan Shah