Nepal Disseminates ECSAT Results

The Ministry of Health and Population of Nepal with support from WHO carried out eye care service assessment using WHO’s the Eye Care Situation Analysis Tool ECSAT – II tool in 2024.  ECSAT is a standardized tool designed to support countries in planning, monitoring trends, and evaluating progress towards implementing Integrated People-Centered Eye Care (IPEC). The tool has systems approach for eye care across six health system building blocks: leadership and governance, service delivery- access, service delivery- quality, human resources and infrastructure, financing, and information systems.  

 The ECSAT technical working group, consisting of members from MOHP, WHO, WHO CC Tilganga Institute of Ophthalmology, and Nepal Netra Jyoti Sangh (endorsed by the steering committee), played a pivotal role in guiding the ECSAT process.  

The findings of the ECSAT assessment tool serve as a crucial document, providing a basis for evidence-based interventions at both policy and programmatic levels. These interventions aim to make eye health care services more affordable, accessible, and equitable within the federal system of Nepal.

High-level Summary of ECSAT in Nepal 

Leadership and governance: Strong leadership is evident, though political commitment could be stronger. Integration across health policies and programmes is largely successful, with room for improvement.  

Eye care service delivery – access: Limited access to eye care disproportionately affects disadvantaged communities. This focuses on the disparity in access between different populations. viii Eye Care Situation. 

Eye care service delivery – quality: The community lacks access to well-researched and effective eye care interventions. This has led to a perception of low quality and limited effectiveness 

Eye care workforce and infrastructure: The team is adequately staffed, with some flexibility to accommodate occasional shortfalls or surges in workload. The necessary infrastructure and equipment are largely available to ensure effective service provision. Spectacles need to be recognised as medical devices.  

Eye care financing: Eye care costs create a financial burden for many. While some health insurance plans cover vision care, these plans often don’t fully address the needs of low-income patients or those requiring ongoing treatment. This highlights the need for a more comprehensive approach to integrating eye care financing into the broader healthcare system.  

Eye care information: A critical need exists for improved data collection on eye care. Limited reporting from the national HIS hinders our ability to assess service utilization, outcomes, and quality.  

Conclusions  

Leadership and Service Delivery: The report acknowledges strong leadership in the eye care program but suggests there’s room for improvement in political commitment and integration across different health initiatives. While access to services is generally good, it disproportionately affects disadvantaged communities. There’s also a concern that the quality of care is perceived as low due to a lack of well-established interventions.   

Workforce, Infrastructure, and Financing: The eye care team is adequately staffed and equipped to handle current needs. However, financial barriers remain a major challenge, especially for low-income patients and those requiring ongoing treatment. The current health insurance plans don’t fully cover eye care costs, including the cost of spectacles, highlighting the need for a more comprehensive financing strategy to improve accessibility and affordability of essential eye care resources.  

Information and Data Collection: There’s a critical need for better data collection within the eye care program. The current limitations in reporting hinder the ability to assess service usage, treatment outcomes, and overall program effectiveness. 

The detailed report can below:

https://mohp.gov.np/resources/reports-surveys-and-findings/en 

Image credit: Nepali Girl checks her eye power regularly with an Optometrist by Rabindra Adhikary