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Human Resources for Health
Published in: Human Resources for Health 1/2016

Open Access 01-12-2016 | Commentary

Setting targets for human resources for eye health in sub-Saharan Africa: what evidence should be used?

Authors: Paul Courtright, Wanjiku Mathenge, Amir Bedri Kello, Colin Cook, Khumbo Kalua, Susan Lewallen

Published in: Human Resources for Health | Issue 1/2016

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Abstract

With a global target set at reducing vision loss by 25% by the year 2019, sub-Saharan Africa with an estimated 4.8 million blind persons will require human resources for eye health (HReH) that need to be available, appropriately skilled, supported, and productive. Targets for HReH are useful for planning, monitoring, and resource mobilization, but they need to be updated and informed by evidence of effectiveness and efficiency. Supporting evidence should take into consideration (1) ever-changing disease-specific issues including the epidemiology, the complexity of diagnosis and treatment, and the technology needed for diagnosis and treatment of each condition; (2) the changing demands for vision-related services of an increasingly urbanized population; and (3) interconnected health system issues that affect productivity and quality. The existing targets for HReH and some of the existing strategies such as task shifting of cataract surgery and trichiasis surgery, as well as the scope of eye care interventions for primary eye care workers, will need to be re-evaluated and re-defined against such evidence or supported by new evidence.
Literature
1.
Stevens G, White R, Flaxman S, Price H, Jonas J, Keeffe J, Leasher J, Naidoo K, Pesudovs K, Resnikoff S, Taylor H, Bourne R, on behalf of the Vision Loss Expert Group. Global prevalence of vision impairment and blindness magnitude and temporal trends, 1990–2010. Ophthalmology. 2013;120:2377–84.CrossRefPubMed
2.
Naidoo K, Gichuhi S, Basáñez M, Flaxman S, Jonas J, Keeffe J, Leasher J, Pesudovs K, Price H, Smith J, Turner H, White R, Wong T, Resnikoff S, Taylor H, Bourne R, on behalf of the Vision Loss Expert Group of the Global Burden of Disease Study. Prevalence and causes of vision loss in sub-Saharan Africa: 1990–2010. Br J Ophthalmol. 2014;98:612–8.CrossRefPubMed
3.
Pizzarello L, Abiose A, Ffytche T, Duerksen R, Thulasiraj R, Taylor H, Faal H, Rao G, Kocur I, Resnikoff S. VISION 2020: The Right to Sight: a global initiative to eliminate avoidable blindness. Arch Ophthalmol. 2004;122:615–20.CrossRefPubMed
4.
World Health Organization. Universal eye health: a Global Action Plan 2014-2019. Geneva: World Health Organization; 2014.
5.
Gogate P, Kalua K, Courtright P. Blindness in childhood in developing countries: time for a reassessment? PLOS. 2009;6(12):e1000177.CrossRef
6.
(no authors). WHO alliance for the global elimination of blinding trachoma by the year 2020. WHO Weekly Epi Rec. 2014,89:421-8
7.
World Health Organization. A framework and indicators for monitoring VISION 2020–The Right to Sight: the global initiative for the elimination of avoidable blindness. Geneva: WHO; 2002.
8.
Dyer G. A manual for VISION 2020 The Right to Sight workshops. London: International Centre for Eye Health; 2005.
9.
Lewallen S, Etya’ale D, Kello A, Courtright P. Non-physician cataract surgeons in Sub-Saharan Africa: situation analysis. Trop Med Int Health. 2012;17(11):1405–8.CrossRefPubMed
10.
Lewallen S, Schmidt E, Williams T, Oye J, Etyaale D, Clark A, Mathenge W, Courtright P. Cataract incidence in Sub-Saharan Africa: what does mathematical modeling tell us about geographic variations and surgical needs? Ophthal Epidem. 2013;20:260–6.CrossRef
11.
Palmer J, Chinanayi F, Gilbert A, Pillay D, Fox S, Jaggernath J, Naidoo K, Graham R, Patel D, Blanchet K. Mapping human resources for eye health in 21 countries of sub-Saharan Africa: current progress towards VISION 2020. Hum Resour Health. 2014;12:44.CrossRefPubMedPubMedCentral
12.
Courtright P, Ndegwa L, Msosa J, Banzi J. Use of our existing eye care human resources assessment of the productivity of cataract surgeons trained in Eastern Africa. Arch Ophthalmol. 2007;125:684–7.CrossRefPubMed
13.
Eliah E, Lewallen S, Kalua K, Courtright P, Gichangi M, Bassett K. Task shifting for cataract surgery in eastern Africa: productivity and attrition of non-physician cataract surgeons in Kenya, Malawi and Tanzania. Hum Resour Health. 2014;12(Suppl1):S4.CrossRefPubMedPubMedCentral
14.
Habtamu E, Eshete Z, Burton M. Cataract surgery in Southern Ethiopia: distribution, rates and determinants of service provision. BMC Health Serv Res. 2013;13:480.CrossRefPubMedPubMedCentral
15.
Bourne R, Stevens G, White R, Smith J, Flaxman S, Price H, Jonas J, Keeff J, Leasher J, Naidoo K, Pesudovs K, Resnikoff S, Taylor H, on behalf of the Vision Loss Expert Group. Causes of vision loss worldwide, 1990–2010: a systematic analysis. Lancet Glob Health. 2013;1:e339–49.CrossRefPubMed
16.
Naidoo K, Raghunandan A, Mashige K, Govender P, Holden B, Pokharel G, Ellwein L. Refractive error and visual impairment in African children in South Africa. Invest Ophthalmol Vis Sci. 2003;44(9):3764–70.CrossRefPubMed
17.
Sherwin J, Lewallen S, Courtright P. Blindness and visual impairment due to uncorrected refractive error in sub-Saharan Africa: review of recent population-based studies. Br J Ophthalmol. 2012;96(7):927–30.CrossRefPubMed
18.
Fricke T, Holden B, Wilson D, Schlenther G, Naidoo K, Resnikoff S, Frick K. Global cost of correcting vision impairment from uncorrected refractive error. Bull World Health Organ. 2012;90:728–38.CrossRefPubMedPubMedCentral
19.
Mash B, Powell D, du Plessis F, van Vuuren U, Michalowska M, Levitt N. Screening for diabetic retinopathy in primary care with a mobile fundal camera—evaluation of a South African pilot project. S Afr Med J. 2007;97(12):1284–8.PubMed
20.
Khan T, Bertram MT, Jina R, Mash B, Levitt N, Hofman K. Preventing diabetes blindness: cost effectiveness of a screening programme using digital non-mydriatic fundus photography for diabetic retinopathy in a primary health care setting in South Africa. Diabetes Res Clin Pract. 2013;101:170–6.CrossRefPubMed
21.
Bastawrous A, Burgess PI, Mahdi AM, Kyari F, Burton MJ, Kuper H. Posterior segment eye disease in sub-Saharan Africa: review of recent population based studies. Trop Med Intl Health. 2014;19:600–9.CrossRef
22.
Kosoko-Lasaki O, Gong G, Haynatzki G, Wilson M. Race, ethnicity and prevalence of primary open-angle glaucoma. J Natl Med Assoc. 2006;98(10):1626–9.PubMedPubMedCentral
23.
Ntim-Amponsah C , Amoaku W , Ofosu-Amaah S, Ewusi R, Idirisuriya-Khair R , Nyatepe-Coo E, Adu-Darko M. Prevalence of glaucoma in an African population. Eye. 2004;18:491–7.CrossRefPubMed
24.
Dean W, Courtright P, Cook C. Does training clinical nurses to test pinhole visual acuity as a screen for glaucoma increase glaucoma referrals to eye care professionals? A pilot study in Malawi. Ophthal Epi. 2012;19(5):293–6.CrossRef
25.
Poore S, Foster A, Zondervan M, Blanchet K. Planning and developing services for diabetic retinopathy in sub-Saharan Africa. Int J Health Policy Manag. 2015;4:19–28.CrossRefPubMed
26.
27.
Courtright P. Childhood cataract in sub-Saharan Africa Saudi. J Ophthalmol. 2012;26:3–6.
28.
Agarwal PK, Bowman R, Courtright P. Child eye health tertiary facilities in Africa. J AAPOS. 2010;14(3):263–6.CrossRefPubMed
29.
Lewallen S, Lansingh V, Thulasiraj RD. Vision 2020: moving beyond blindness. Int Health. 2014;6(3):158–9.CrossRefPubMed
30.
Chibuga E, Massae P, Geneau R, Mahande M, Lewallen S, Courtright P. Acceptance of cataract surgery in a cohort of Tanzanians with operable cataract. Eye. 2008;22:830–3.CrossRefPubMed
31.
Dadaci Z, Acir NO, Borazan M. Self-declaration of diabetes and factors associated with having regular eye examinations among patients with type 2 diabetes in Turkey. Eur J Ophthalmol. 2015;29:0. doi:10.​5301/​ejo.​5000562.
32.
Munachonga E, Hall A, Courtright P. Examination of first-degree relatives of patients with glaucoma: a randomized trial of strategies to increase use in an eye hospital in Africa. Ophthalmic Epidemiol. 2007;14:155–9.CrossRefPubMed
33.
Mutale W, Bond V, Mwanamwenge M, Mlewa S, Balabanova D, Spicer N, Ayles H. Systems thinking in practice: the current status of the six WHO building blocks for health system strengthening in three BHOMA intervention districts of Zambia: a baseline qualitative study. BMC Health Serv Res. 2013;13:291.CrossRefPubMedPubMedCentral
34.
Adepoju FG, Ayanniyi AA, Pam V, Akanbi TB. Human resource development for VISION 2020 in developing countries: a change from absolute numbers. Eur J Ophthalmol. 2011;21:820–5.CrossRefPubMed
35.
Eze BI, Maduka-Okafor FC. An assessment of the eye care workforce in Enugu State, southeastern Nigeria. Human Res Health. 2009;7:38.CrossRef
36.
Thylefors B. The WHO, programme for the prevention of blindness and cataract in developing countries. Doc Ophthalm. 1992;81:339–44.CrossRef
37.
Palmer J, Chinanayi F, Gilbert A, Pillay D, Fox S, Jaggernath J, Naidoo K, Graham R, Patel D, Blanchet K. Trends and implications for achieving VISION 2020 human resources for eye health targets in 16 countries of sub-Saharan Africa by the year 2020. Hum Resour Health. 2014;12:45.CrossRefPubMedPubMedCentral
38.
Alemayehu W, Melese M, Bejiga A, Worku A, Kebede W, Fantaye D. Surgery for trichiasis by ophthalmologists versus integrated eye careworkers: a randomized trial. Ophthalmology. 2004;111:578–84.CrossRefPubMed
39.
Habtamu E, Rajak S, Gebre T, Zerihun M, Genet A, Emerson P, Burton M. Clearing the backlog: trichiasis surgeon retention and productivity in Northern Ethiopia. PLoS. 2011;5(4):e1014.
40.
Lewallen S, Mahande M, Tharaney M, Katala S, Courtright P. Surgery for trachomatous trichiasis: findings from a survey of trichiasis surgeons in Tanzania. Br J Ophthalmol. 2007;91:143–5.CrossRefPubMed
41.
Gichangi M, Kalua K, Barassa E, Eliah E, Lewallen S, Courtright P. Task shifting for eye care in eastern Africa: general nurses as trichiasis surgeons in Kenya, Malawi, and Tanzania. Ophthal Epidem. 2015 (in press)
42.
ICTC. Global scientific meeting on trachomatous trichiasis. International Coalition for Trachoma Control; 2012.
43.
Kalua K, Gichangi M, Barassa E, Eliah E, Lewallen S, Courtright P. Randomised controlled trial to investigate effects of enhanced supervision on primary eye care services at health centres in Kenya, Malawi and Tanzania. BMC Health Serv Res. 2014;14 Suppl 1:S6.CrossRefPubMedPubMedCentral
44.
Kalua K, Gichangi M, Barassa E, Eliah E, Lewallen S, Courtright P. Skills of general health workers in primary eye care in Kenya, Malawi and Tanzania. Hum Resour Health. 2014;12 Suppl 1:S2.CrossRefPubMedPubMedCentral
45.
Byamukamaa E, Courtright P. Knowledge, skills, and productivity in primary eye care among health workers in Tanzania: need for reassessment of expectations? Int Health. 2010;2:247–52.CrossRef
46.
Andriamanjato HH, Mathenge W, Kalua K, Courtright P, Lewallen S. Task shifting in primary eye care: how sensitive and specific are common signs and symptoms to predict conditions requiring referral to specialist eye personnel? BMC Human Resources for Health. 2014;12 Suppl 1:S3.CrossRef
47.
Laviers H, Burhan I, Omar F, Jecha H, Gilbert C. Evaluation of distribution of presbyopic correction through primary healthcare centres in Zanzibar. East Africa Br J Ophthalmol. 2011;95:783–7.CrossRefPubMed
48.
Du Toit R, Faal HB, Etyaale D, Wiafe B, Mason I, Graham R, Bush S, Mathenge W, Courtright P. Evidence for integrating eye health into primary health care in Africa: a health systems strengthening approach. BMC Health Serv Res. 2013;13:102.CrossRefPubMedPubMedCentral
49.
Courtright P, Seneadza A, Mathenge W, Eliah E, Lewallen S. Primary eye care in sub-Saharan Africa: do we have the evidence needed to scale up training and service delivery? Ann Trop Med Parasitol. 2010;104:361–7.CrossRefPubMed
Metadata
Title
Setting targets for human resources for eye health in sub-Saharan Africa: what evidence should be used?
Authors
Paul Courtright
Wanjiku Mathenge
Amir Bedri Kello
Colin Cook
Khumbo Kalua
Susan Lewallen
Publication date
01-12-2016
Publisher
BioMed Central
Published in
Human Resources for Health / Issue 1/2016
Electronic ISSN: 1478-4491
DOI
https://doi.org/10.1186/s12960-016-0107-x

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