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Advocacy to Action – Stories from the regions – Ghana

Published: 18.10.2023
Dr Boateng Wiafe Technical Advisor
Operation Eyesight Universal
Advocacy to Action – Stories from the regions - Ghana
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Shaping Ghana’s eye care landscape – the journey of collaboration  

Amidst the difficulties in Ghana, this initiative sets an inspiring example of eye care advocacy. Adopting the public-private partnership approach, they used evidence though a survey to bolster their advocacy efforts such as reducing the prices of Glaucoma medications. Despite the challenges, an impact was made, and it becomes an inspiring story of success. It is also an instance of making this sustainable through a network of stakeholders.  This instance exemplifies some of the key aspects of successful advocacy from the “Advocacy for Eye Health: A Beginner’s Guide” such as use of scientific evidence to bolster credibility, inclusiveness, and enhancing the project’s resilience.  

Background 

In 2020 in Ghana, their crude prevalence of blindness was estimated to be 0.32% according to VLEG.1 . There was a dearth of critical evidence that can inform advocacy priorities and a need emerged to conduct a population-based national survey. A well planned and executed public private advocacy model resulted in compelling evidence for the government to take action However, the budget to conduct such a survey was beyond the reach of only one organization.   

The global eye health action plan 2014–2019 aimed to reduce avoidable visual impairment as a global public health problem and to secure access to rehabilitation services for the visually impaired.  The 3 objectives recommended are:   

  • The need for generating evidence on the magnitude and causes of visual impairment and eye care services and using it to monitor progress, identify priorities and advocate for greater political and financial commitment by Member States to eye health. 
  • The development and implementation of integrated national eye health policies, plans and programmes to enhance universal eye health with activities in line with WHO’s framework for action for strengthening health systems to improve health outcomes. 
  • The multi-sectoral engagement and effective partnerships to strengthen eye health. 

To generate evidence, we set out to conduct a national blindness and visual impairment survey to know where we are with several years of investments and service provision.

Strategy  

We approached several partners but only one agreed to partner with us, despite the fact that each and everyone thought it was a brilliant idea and a very useful initiative.  Then the third objective came to mind. “The multi-sectoral engagement and effective partnerships”. We decided to use the Public Private Partnership (PPP) approach which worked. 

Engaging stakeholders 

 One of our Partner meetings in Accra Acknowledgement- Credit to Eye Care Secretariat of the Ghana Health Service.
One of our Partner meetings in Accra. Credit to Eye Care Secretariat of the Ghana Health Service

Our approach on the PPP model made government agencies, private sectors, non-governmental organizations our stakeholders in the project. In this mode of engagement, we worked with  

1. Government agencies:

  • The Ministry of Health through the Ghana Health Service supported in “kind” – Seconding Ophthalmologists, Optometrists. Ophthalmic Nurses for the entire period of the survey. The Ministry also released vehicles for the use of the research teams for the entire period of the survey. 
  • The Ghana College of Physicians and Surgeons faculty of Public Health – Study design, ethical clearance, monitoring, and final report writing. 
  • The Ghana Statistical Services – seconded staff to assist in the statistical calculations and analysis of the data.  

2. Private Sector
 The Standard Chartered Bank through the Seeing is Believing project provided some financial support. 

3. Non-Governmental Organizations
 Swiss Red Cross and Operation Eyesight Universal also provided some funding as well. 

Impact  

The impact of this was phenomenal.   

The results of the survey triggered these benefits. (See Table below) 

 

Results of the Survey  Advocacy outcome 
Cataracts account for about 55% of the blind population in Ghana  Birth of National Cataract Outreach Program (NCOP) – Himalayan Cataract Project and other partners are supporting Cataract Surgery outreach around the country, helping to increase the CSR 
Glaucoma accounts for 19.4% of the blind population  Advocacy to Govt for the reduction of the prices of Glaucoma medication in Ghana 
Only 5% of people with refractive error actually have eyeglasses – translating to a backlog of about 7 million pairs of eyeglasses  Several NGOs with affordable glasses in Ghana now.  Advocacy tool for National Health Insurance to include eyeglasses on the list of commodities 

 

Lessons Learned  

  1. Always think outside the box: We in the Ophthalmic space have always stayed within our circle.  Let us try to go out and seek like-minded groups who will be interested to help achieve a common goal. 
  2. Roles and Responsibilities: There has to be an agreement/memorandum of understanding clearly setting out the roles and responsibilities of each partner. 
  3. Active engagement: Active engagement of all Stakeholders is very key to success.  
  4. Cost-effectiveness:    With such an approach the cost to each stakeholder becomes affordable. 
  5. Where there is a will, there is always a way: It was going to be very easy to give up looking at the budget involved.  But we saw the need for such a project, and it has had a ripple effect. 

Authored by Dr Boateng Wiafe, Technical Advisor, Operation Eyesight Universal  

Our Advocacy to Action 2023 Regional sessions are opportunities for successes and lessons learnt to be shared more widely across the sector. The sessions also support and inform advocates with relevant tools and resources available from IAPB and global bodies. Advocacy for Eye Health- A Beginner’s Guide takes you through 5 essential steps to build an effective advocacy project along with how to make a powerful case on eye health. Refer to more such toolkits and resources in our Advocacy Hub.  

Refer to Vision Atlas for more insights on regions and countries, which has a rich mix of the latest eye health data, narrative, and presentation tools.  Our Knowledge Hub brings together evidence, information, key opinions, resources, guides, tools, and the sharing of member experiences on the most important topic areas in global eye health.