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Dear Readers,
The prevalence of blindness and visual impairment is high and use of services is limited. The Global Initiative for the Elimination of Avoidable Blindness (VISION 2020: The Right to Sight) sets a major challenge requiring a significant increase in the provision and uptake of eye care services.
This issue of sitenews focuses on various aspects of eye care barriers that are there from both providers and receivers perspective. It high lights the various barriers to uptake of eye care services. The reasons for non utilization of eye care services. There is a huge collection of resources which enlightens the readers on barriers for adherence. Also resources providing different models of demand generation in eye care are provided.
The featured website is South African National Council for the Blind (SANCB).
Hope this issue will impart the resources which are worth to be read. Looking forward to come up with more resources in future.
We wish you an experience of learning that is very practical. Your feedback will let us know how we can improve. Please write in your feedback at eyesite@aravind.org. We look forward to your feedback.
We wish our readers an informative reading!

Happy reading!
Regards,
Vision 2020 e-resource team
The Issue Features...
Eye Care Barriers
Vol. 5 No. 4 April 2008
•   Barriers to Uptake of Eye Care Services
- Disease
- Community/Hospital Based
•   Utilization of Eye Care Services
•   Barriers for Adherence or Compliance
•   Demand Generation
•   Featured Organization

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Determining barriers to use of eye care services is critical for planning strategies to prevent blindness. Traditional practices, beliefs, fatalistic attitudes towards blindness, fear of treatment, lack of faith in the intervention, and fear about the surgical procedure influence the behavior of patients, leading to low acceptance levels. These are the principal barriers that would have to be addressed if uptake of services is to be improved. Health education, individual counseling, and using operated patients as motivators can help overcome this problem.

Disease Community/Hospital Based

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One of the major challenges facing health care providers in general and eye care providers in particular, is the inequity in the provision and utilization of care. This is often the result of mal-distribution of the infrastructure necessary for the provision of care. However, it is well recognized that universal coverage in itself will not guarantee access to and uptake of care. Even when eye care services are available and affordable, utilization and quality vary across population groups based on socioeconomic status, literacy, and other culturally based factors. The analysis of the reasons for poor uptake, and the enumeration of the measures necessary to be taken to enhance the utilization of services, are of critical importance if increased coverage is to be equated with enhanced utilization.
- Dr. Pararajasegaram, WHO consultant
  • IMPORTANCE OF AFFORDABLE EYECARE

  • Abstract:
    This articles focus primarily on the supply issues of eye care service delivery, looking particularly at how increasing operational and manufacturing efficiencies can reduce costs to an affordable level.

  • SOCIAL MARKETING FOR EFFECTIVE EYE CARE DELIVERY

  • Abstract:
    This article describes how the effective Social Marketing helps to create understanding and improves the quality of eye care services through an information campaign clear any misconceptions in the community.

  • AWARENESS OF EYE DISEASES IN AN URBAN POPULATION IN SOUTHERN INDIA

  • Abstract:
    The objective of the study is to assess the level of awareness of eye diseases in the urban population of Hyderabad in southern India.

  • WILLINGNESS AND ABILITY TO PAY FOR CATARACT SURGERY: A STUDY IN TANZANIA

  • Author: Dr Susan Lewallen, Dr Robert Geneau, Mr Michael Mahande
    Abstract:
    This report and study were undertaken with the broad aim of learning about the capacity and willingness to pay for cataract surgery in Tanzania.

  • CATARACT SERVICES: INCREASING UTILISATION AND CREATING DEMAND

  • Abstract:
    This article describes a dramatic illustration from China showing the imbalance between the provision and use of cataract services; a fully equipped department, with advanced technology and 24 ophthalmologists, performed less than 100 cataract operations in a year. It also suggests the need for balance between supply and demand and making the cataract services more affordable.

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      An estimated half of those for whom medicines are prescribed do not take them in the recommended way. Until recently this was termed "non-compliance", and was sometimes regarded as a manifestation of irrational behavior or willful failure to observe instructions, although forgetfulness is probably a more common reason. But today health care professionals prefer to talk about "adherence" to a regimen rather than "compliance".
      There have been many studies of the effects of different strategies in improving adherence to therapy. These include reducing the frequency of administration during the day and reducing the numbers of medicines a patient has to take. However, there is no evidence that such measures are effective.
      Nevertheless, it seems likely that adherence can be improved by taking care to explain the benefits and adverse effects of a drug. In a busy clinic it is too easy for the prescriber to give out a prescription with little or no explanation. It also makes sense to reduce the frequency of taking medicine to once or twice a day: though again, there is no evidence that this tactic is effective. Causes for poor compliance are:
      Forgetfulness
      Prescription not collected or not dispensed
      Purpose of treatment not clear
      Perceived lack of effect
      Real or perceived side-effects
      Instructions for administration not clear
      Physical difficulty in complying (e.g. opening medicine containers, handling small tablets, swallowing difficulties, travel to place of treatment)
      Unattractive formulation, such as unpleasant taste
      Complicated regimen
      Cost factor

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      People's use of health services is influenced by a range of psychological, social, cultural, economic and practical factors. Eye care services are no exception. Nevertheless, there has been a tendency to assume that if eye services are available then people in need will use them. But in areas with poor utilization of services there is need for demand generation. This section will provide you with resource related to demand generation. It will help you to develop various demand generation strategies which can be used to get more patients.
  • HOW TO CREATE DEMAND

  • Abstract:
    This article briefs about the barriers which prevent from accessing the cataract services in India. It also describes how the effective Social marketing helps for preventing these barriers.

  • USEFUL RESOURCES: INCREASING UPTAKE AND GENERATING DEMAND FOR CATARACT SERVICES

  • Abstract:
    This is a web search for few resources from KCCO.

  • DELIVERY OF EYE CARE TO THE ELDERLY: PRACTICAL CONSIDERATIONS

  • Abstract:
    This article describes the perspective of the elderly people about cataract. It also the global thought of the elderly people for treatment their mentality. It also clearly suggests how the socio economic barriers while treating the elderly people for cataract will be effectively tackled by providing quality and eminent service for the poor people. It also tells how the demand for the prevalence of blindness could be increased for the elderly people.

  • INCREASING UPTAKE OF EYE SERVICES BY WOMEN

  • Abstract
    This article briefs about the factors which affect the women from reaching for the eye care services and how this strategy has been quietly changing in various parts of the world and how this could bee achieved with the help of counselling.

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South African National Council for the Blind (SANCB)
      The South African National Council for the Blind (SANCB) is a Non-Government Organisation (NGO) striving to meet the needs of all blind and partially sighted people in South Africa.
      The services include rehabilitation, education and training, the provision of assistive devices, social and economic development and programmes promoting the prevention of blindness and the restoration of sight.

      Now in its 78th year of operation, the SANCB comprises a head office, nine provincial offices and 95 member organisations, which include workshops, self-help groups and 19 schools for blind and partially sighted learners making it the largest NGO in South Africa. It is affiliated to several international organisations.

We are committed to:
  • Fostering and promoting conditions to enable all blind and partially sighted people of all ages to live dignified, productive and meaningful lives;
  • Consulting with and lobbying all relevant institutions and individuals in government, public and private sectors, on matters relating to policy and legislation pertinent to the interests of blind and partially sighted persons.
  • Developing and maintaining standards for services offered to blind and partially sighted people;
  • Promoting the education, learning and skills development, and opportunities for employment of blind and partially sighted people;
  • Helping organisations for and of the blind to deliver effective and relevant services to blind and partially sighted people and their families or other interested stakeholders;
  • Gathering, disseminating and managing information on matters concerning blindness and related services to and on behalf of blind and partially sighted people;
  • Initiating, developing and implementing projects that benefit blind and partially sighted people of all ages.
  • Promoting and engaging in relevant research;
  • Producing and promoting the accessibility of assistive devices and related technologies to blind and partially sighted people;
  • Preserving and restoring sight and preventing blindness;
  • Co-operating with and exchanging information, advice and assistance with organisations and agencies in South Africa, Africa and the rest of the world concerned with the improvement of the quality of life of blind and partially sighted people;
  • Promoting knowledge of the skills, capacities and abilities of blind and partially sighted people;
  • Resisting the marginalization of blind and partially sighted people in every way; and
  • Ensuring that blind and partially sighted people of all ages enjoy all rights promised by the Constitution of South Africa.
Visit our website : www.sancb.org