CBM/BHVI Nigeria Child Eye Health - the importance of advocacy to address barriers revealed by KAP study - The International Agency for the Prevention of Blindness

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SiB Nigeria teamNigeria, with a population of 180 million people, is among the most populous countries in Africa. Data from the Nigeria National Blindness and Visual Impairment study (2006 -2007) stated that 0.6 percent of children suffer blindness and visual impairment. Cataract, trachoma, congenital glaucoma, and paediatric retinoblastoma are the leading causes of impaired vision. Others include: conjunctivitis and cornea ulceration caused by eye injury, measles, vitamin A deficiency and refractive error. Hospital-based studies revealed that over 70% of blindness in children is avoidable and that 80% of the conditions are treatable (WHO).

The Federal Ministry of Health, through the National Eye Health Unit of the Department of Public Health, develops policy related to eye-health within the Nigerian government and serves to provide direction and coordination in all matters related to the prevention of blindness and the rehabilitation of the blind. However, child eye health is still at the rudimentary stage in Nigeria. Though, it is speculated that a policy exists, in the health policy 2016, eye care is faintly mentioned but mostly included as a part of neglected tropical diseases. Specific policies and strategic framework for implementation of child eye health are unavailable at these levels. So far, there is no strong government commitment to child eye health in Nigeria.

In order to garner support and generate the needed enabling environment for implementation of the Seeing is Believing (SiB) Comprehensive Child Eye Health programme in Nigeria (CCEHiN), the programme coordination unit initiated advocacy visits targeted at the governments of the various SiB programme states between the months of October and December 2017. The purpose of the visits was to advocate for support, inclusion of child eye health into state-level strategic plans where possible, and discuss modalities for sustaining implementation of the SiB programme at its closure in 2020.

Preliminary findings from the SiB Knowledge, Attitude and Practices (KAP) study (2017) revealed that ignorance, rumours and misconceptions, economic barriers and lack of transportation are among the key impediments inhibiting most community members from accessing child health eye health care services in Nigeria. Under the SiB programme, one of the main problems identified was the challenge of how to ensure that all the children referred for eye health services from the various communities are able to access care, and are properly followed up on, so they do not miss out of the opportunity provided by the SiB programme to receive treatment. This can address catastrophic consequences of eye conditions such as permanent sight damage and blindness.

Mr Duro Onota was at the SiB inception meeting and enunciated on the benefits that could be derived from the SIB programme if implemented as planned. According to Mr Onota, “It is no doubt that a clear sight is very important and necessary for the full realization of an individual’s potentials and life’s ambition. The CBM and the Standard Chartered Bank’s Seeing is Believing (SIB) programme aims at making this happen. Over 80 percent of what we learn and do is through sight. Therefore it is important to prevent sight loss by all means and as early as possible. My personal experience provides clear evidence to support this claim. In secondary school, I could no longer see clearly what was written on the blackboards that we used at the time. By the time my parents noticed what was happening to me, they could not understand the issue, so they became hostile to my visual inconsistencies.

My educational ambition was to go the way of the sciences and take up any of the science related professions especially those that are related to Chemistry, Botany and Zoology. But this was not to be because my sight went bad unchecked early at the onset.

It was a thing of great joy to me to know during the inception meeting of the SiB programme for cluster 2 in Akwanga Nasarawa State that children in both Primary schools and Junior Secondary Schools were going to have the privilege of eye care services to detect and prevent sight loss. By this exercise, many children who probably would have gone blind in adulthood would be saved from that experience. This also means that the children would be able to pursue their educational and professional ambitions unhindered by the lack of good sight. Besides, the SIB programme will be reaching many of those that would never have been reached by the public health system. The SIB programme is definitely an important gap filler in the area of eye care in the existing public health system. Parents who would have done nothing about the failing sight of their children as a result of poverty and ignorance would be saved from that trouble by the Seeing is Believing (SiB) programme.

Finally, I would like to thank the sponsors of the Seeing is Believing programme and the entire personnel engaged in executing this project for the benefit of humanity”.

The advocacy visits yielded positive outcomes; Cross River and Plateau States were able to integrate child eye health into their State Strategic Health Development Plan. Others pledged to follow suit and ensure that it is budgeted for through school health funding. Kano State asserted to support the SiB outreach teams by releasing ambulances that will be used to convey children referred for eye health services to the referral sites in order to ensure that they obtain services. The SiB programme coordination unit intend to continue following up on the welcome commitments made by the various States.