Sustainability of School Eye Health (Singida, Tanzania)

The project works in partnership with the Ministry of Health, Community Development, Gender, Elderly and Children (MoHCDGEC), the Ministry of Education, Science and Technology (MoEST) and the Regional Authority in all seven districts of Singida. The main purpose of the project is to contribute to the sustainable provision of school eye health for primary school pupils and community members in the Singida region.

Strategies to ensure sustainability

Awareness creation for parents

To support the outreach activities, create awareness and increase sustainable demand for eye health services IEC materials were designed, printed and disseminated. Thirty banners, 230 brochures, 10 billboards and 10 wall murals were developed showing information on eye health The materials were distributed across all seven districts (in schools and health centres) as well as to government leaders and influential people. Some of the billboards are displayed along the main roads. This will strengthen community knowledge on eye health and encourage attendance at eye screening events in the schools and health facilities.

Advocacy

Meetings with health management teams in each district have taken place during the preparation of their comprehensive health plans. Councils have committed to allocate funds address gaps and ensure sustainability for eye care in their respective districts. For example, Manyoni District have incorporated into their annual financial plan:

2 days orientation on child eye health to 5 eye care staff by June 2020 (at a cost of 5,000,000 Tshs, or approx. 2,200 USD)
procure 2 sets of furniture for the eye department by June 2020 (at a cost of 5,000,000 Tshs, or approx. 2,200 USD)
facilitate three outreach events for eye screening and treatment in to health centres (Kintiku and Manyoni) by June 2020 (at a cost of 5,680,0000 Tshs or approx. 2,500 USD).

Technical support is provided to ensure adequate systems are in place to monitor income and expenditure from the eye health department. Guidelines have also been established for cost recovery and how the funds generated from the eye health department can be used to improve financial sustainability and facilitate access to eye care services for school children.

The project has advocated for child eye care services to become one of the key agenda points for the Ministries of Health and Education.

Establishment of Vision Centres to ensure refractive error services are available for children

Refractive error services are carried out in Vision Centres at the district level. Sightsavers has supported Singida Regional Hospital and two district based hospitals (Iramba and Manyoni) with the equipment for optical eye care units. The optical units (workshops) are providing custom made glasses for astigmatism and refractive error prescriptions.

School eye health services embedded into the Ministry of Health

The school eye health project works closely with MoHCDGEC and MoEST, bringing together the education and health sectors into an integrated project which aims to support quality-learning outcomes for pupils in primary schools. School eye care services are now an agenda item for both sectors. Health teams, alongside two trained teachers per school provide eye health services to the pupils. The education teams support with logistics. Training that has been conducted with more than a thousand teacher, will support eye health awareness in primary schools going forward. The group of students that have benefitted from eye health services and been provided with glasses will act as ambassadors for eye health services and the benefits of correcting refractive error.

Sustainability Challenges and how to overcome them

Some parents of pupils who were prescribed with spectacles did not turn up during the outreach sessions due to the popular belief that glasses make people go blind. The project continues to follow up to make sure all parents of those pupils who are prescribed are seen and given education on the importance of wearing their spectacles. We hope that they will be dispensed as a result of the increased awareness on eye health.

The findings showed that the main barrier to spectacle uptake was a lack of awareness, but as the awareness of the benefits of wearing spectacles increases, there is an enthusiasm for purchasing and wearing spectacles.

The government does not allocate funds for refractive error services for children due to the low government budget. The project continues to advocate for the prioritisation of refractive error services for children, especially given the impact poor vision can have on school attendance and educational attainment.

Sightsavers will continue to work directly with the government authority in Singida through the Ministry of Education and the Ministry of Health, Community Development, Gender, Elderly and Children for effective and quality programming while ensuring the sustainability of the project outcomes.