HCP Cureblindness Strengthens Primary Eye Care in Ethiopia through Training and Policy Support

Since 1995, HCP Cureblindness has worked with country partners to build sustainable eye care systems. HCP does this by focusing on building local capacity, ensuring quality infrastructure, enabling quality patient care and aiding effective prevention. HCP has been working in Ethiopia since 2008.

While Ethiopia has made some amazing progress towards achieving several of the UN’s Sustainable Development Goals, gaps still exist in their primary healthcare space. Almost 80% of Ethiopians live in rural areas with limited or no access to eye health services.

According to the unpublished Rapid Assessment of Avoidable Blindness (RAAB) surveys conducted in west Gojam zone of Amhara region and Jimma zone of Oromia regions, the prevalence of blindness in people aged 50 years and above is 3.0% and 3.1% respectively. The Jimma zone RAAB revealed that 88.4% of blindness cases are avoidable, with 57.9% cases curable and 30.5% preventable. It also stated that the prevalence of blindness is 40% more among women than men. The West Gojam zone survey revealed that bilateral blindness in people aged 50 years and above was 3.0% (2.5% in males and 3.4% in females). This is in large part due to a lack of access to eye health service.

Blindness is related to multiple development outcomes, including gender inequality, reduced economic output and higher mortality. Data tells us that females are less likely to seek or receive care than males.  Around 94% of women surveyed cited transportation, limited funds, and/or the distance to qualified healthcare among the most common obstacles to primary eye care, including screenings.

Ethiopia was among the first to accept WHO’s recommendations of Integrated People-centered Eye Care (IPEC) and conducted the Eye Care Situation Analysis Tool (ECSAT) in 2021. Based on these findings, and HCP Cureblindness’ own survey of policies on the eye health system, HCP initiated the implementation of IPEC in selected parts of Ethiopia with support from the pharmaceutical giant, Novartis.

HCP is also working directly with the Federal Ministry of Health (FMoH), Ethiopia, to ensure IPEC principles and policies are included in the revised National Eye Health Strategic Plan 2024-2026.

“Investments in primary health care have been shown to improve health outcomes worldwide. Unfortunately, comprehensive eye health is rarely included – even though vision enables a range of everyday activities that are critical to global progress and our collective achievement of Sustainable Development Goals. Our programme partnering with the Ministry of Health in Ethiopia is building capacities of the local health force at all levels and strengthening primary eye health for all, focusing on dominant causes of blindness in the country,” said K-T Overbey, CEO, HCP Cureblindness.

To improve access to eye health in rural Ethiopia, HCP began with training of primary health care providers, strengthening of referral pathways, and advocating for the integration of eye health in the wider health system of the country. Since 2022, HCP has trained 60 Ophthalmic Nurses (ONs) and optometrists, who staff the Primary (PECU) and Secondary Eye Care Units in rural areas of three regions in early diagnosis, effective medical management and referral protocols for patients with corneal diseases, glaucoma, and diabetic retinopathy (DR). Post-training assessment showed an improved capacity of PECU staff to diagnose, treat, and refer patients with the above-mentioned eye conditions. There was an 80% increase in patients seen, 122% increase in patients treated and 62% decrease in patients referred to tertiary care centers.

Critical diagnostic equipment and supplies were distributed to several eye care units situated in the Southwestern, Oromia, and Amhara regions in line with FMoH standards as set out in the National Strategic Plan for Eye Health 2016-2020. Our Policy and Advocacy team continues to work with key stakeholders at the regional level including hospital CEOs, Regional Health Bureaus, Regional Finance Bureau and district government offices to address the gaps in accessing eye care at the PECU level including advocating for more investment in primary care infrastructure.

In addition, we trained 200 Health Extension Workers (HEWs) from Seka, Agaro, Dabat and Chilga districts to generate awareness among communities on eye health. They were also sensitized on the local gender dynamics. A comparative analysis between the pre- and post-training phases revealed an incredible 77% enhancement in the knowledge base of HEWs, empowering them at elevating awareness about eye health and making informed referrals to PECUs.

The program interventions of community awareness are embedded within the existing system of the Government of Ethiopia, building capacities of community health workers who remain the on ground cadre that will support community health, even beyond the program timeframe. The policy and advocacy program interventions anticipate inclusion of eye care in national health plans and will support the broader sustainability of empowering community health workers to provide critical first aid care and referral as a core component of primary health care.

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1 (World Economic Forum)