2.3: Operational planning

Once the goals and objectives of the programme have been clearly stated, it is time to reflect on the activities and operational procedures of the programme. Evidence-based protocols should be  chosen based on available personnel (eg WHO screening implementation guidelines, REACH,  WCO Paediatric resource).

Resources needed

Based on the previous steps, resources should be estimated for each component of the programme.

Human resources

• Screeners
  • Teachers are sometimes a cost-effective workforce, but they need constant training and motivation, which can be one of the most expensive components in screening programmes. Community-level workers such as allied health workers or school nurses show better outcomes for screening. Consideration for integrated screeners who can screen other health areas like hearing and oral health.
• Eye care providers
  • When available, eye care professionals are a great addition to the screening teams. Ophthalmologists, optometrists or optometry students can provide detailed examinations on site based on their competencies and national legislation (retinoscopy, refraction, cycloplegia, binocular vision). Delivery of eye care in school minimises drop out in attendance of referrals but comes with a cost. If such professionals are not available for school screenings, trained health professionals such as vision technicians, refractionists, allied ophthalmic personnel or ophthalmic nurses can do a triage following initial screening and refer as appropriate.
• Managing team
  • All programmes will need to be well managed. Managers with clearly defined roles and responsibilities should provide oversight of implementation, and manage the financial, human and other resources. Managers will be responsible for reporting on progress and for financial accountability to donors, Ministries and other stakeholders. They are also usually responsible for initiating midterm reviews and end of programme evaluations. The overall processes and procedures of the programme will have to be governed in a manner that ensures the provision of quality eye health services to children in a way which promotes equity.

Financial resources

• The different components of the plan should be costed, and funding sought from the government, non-governmental organizations, community based and service organisations and commercial enterprises willing to support the programme.

Material resources

• Child-specific material, with locally-affordable instruments, technologies, topical medications and spectacles based on the selected protocol
• Health promotion material : locally-relevant material should be developed. Community, parents, teachers and children should be involved in health promotion activities to ensure compliance after screenings.

The design of your school health intervention will impact the materials and resources required, the training needs and human resources and the extent of service provision being offered during different phases of the program. For example, an integrated screening day may include screening and some basic provision of services such as glasses as well as referral but a school eye health program may only include the delivery of eye health awareness by teachers and basic screening, with children referred to trained services if needed.