Rural Eye Health – An impact waiting to be achieved

India is home to the largest population of blind people in the world. Over 12 million people in India are blind, of which nearly 88% of the blindness was unavoidable. In majority of the cases, the primary causes are found to be cataract and refractive error. Both causes can be easily resolved with timely interventions. Cataract can be treated by a small surgery which has been taking place for at least 200 years and refractive error can be cured with a pair of glasses. Yet millions in India go blind due to lack of awareness and availability of basic infrastructure that can solve these problems. While blindness is not fatal it still is a massive contributor to poverty. Once a person goes blind, he/she becomes most vulnerable to loosing opportunities such as access to livelihood, education, financial independence and eventually respect or recognition with in the society. Therefore, a blind person has to go through these hardships only because they did not receive timely treatment.

The problem is particularly prevalent amongst marginalised communities like tribal, schedule castes, minorities and even higher amongst women in these communities. By some estimates nearly 70% of blind people live in 8 backward states of Uttar Pradesh, Madhya Pradesh, Chhattisgarh, Rajasthan, Bihar, Jharkhand, West Bengal, and Odisha. To tackle this challenge Sightsavers is working in 100 most deprived districts of these states. As a part of its new strategy (2021-2025) which is aligned with the latest amendment to the CSR law, the organization has developed a model called “High Impact District”. Under this initiative the organization shall work systematically in ensuring that the prevalence of blindness in the identified districts called “HI Districts”, falls to less than 0.3% which is at par with the developed nations. The intervention will also contribute to the achievement of many Sustainable Development Goals (SDGs), such as poverty reduction, zero hunger, good health, quality education, gender equality, reduced inequalities, and decent work.

As of now Sightsavers has identified 17 districts in which this initiative shall be initiated, however the aim is to eventually have all 100 districts converted into HI districts. Kalahandi, Odisha & Jhabua, Madhya Pradesh are the two extremely backward districts and have high percentage of tribal population. However, irrespective of whether the literacy levels here in these 2 districts increase or not, whether tribal population have better access to land that they have called home for centuries or not, whether the people of these districts benefit out of the minerals extracted from their land, one thing for sure that will change is the fact that no one will be needlessly blind in 5 years’ time. Sightsavers shall ensure that the prevalence of blindness in these districts and many more such districts will be as low as in the developed cities of Western Europe or America.

Over a period of 5 years, Sightsavers will ensure that all the HI districts have access to affordable and quality eye care services. There are 3 strategic focus areas of HI districts-

• Creating community awareness on eye health,
• Strengthen eye health systems and
• Creating an enabling environment for the various stakeholders to contribute to eye health.

Since all the HI districts are the districts where there have been hardly any eye health services available, there is a huge unmet demand that has built up over decades. To ensure that the prevalence of blindness is brought below 0.3% and a sustainable eye health system is established in these districts in 5 years, Sightsavers will collaborate with various stakeholders such as state governments, district authorities, and eye hospitals. The HI district program is designed to keep in view the principles of universal eye health, which entails the provision of comprehensive eye health services to everyone and the integration of eye health services into the wider health system.  The program will ensure that even vulnerable groups like women, senior citizens, people with disabilities, transgenders, tribal or SC communities, and people residing in the most remote locations equitably have access to these services.

As a part of system strengthening, all the stakeholders – Govt departments, hospital partners, and local authorities will be oriented and sensitized to develop a comprehensive plan for the entire district. In every block, Sightsavers will establish vision centres, invest in necessary human resources & training clinical and non-clinical staff, conduct eye camps to provide quality health services to all individuals in each block. A referral system will be established in each district so that every person identified with some potential eye problem can avail of further treatment at private secondary and tertiary facilities or public health units such as PHCs, CHCs, and district hospitals.

Sightsavers strongly believe that only empowerment and ownership of the community can bring sustainable changes. Active participation of Panchayats, local Self-help groups, and community volunteers will create awareness on the importance of eye health and availability of services in the community and bring about a lasting change in the eye health-seeking behaviour of the community. For sustainable high-impact intervention, it is necessary to create an enabling environment for all the stakeholders to contribute. MOUs will be signed at the state level to ensure that policies are developed and implemented in alignment with principles of universal eye health. Finally, Sightsavers will engage in various activities for measuring impact, such as developing a robust MIS, collaborating for evidence generation, setting up a community-based monitoring system, and engaging in structured studies.

Sightsavers is looking for corporate and Institutions who would like to partner with Sightsavers in this High Impact journey.

Jatin Tiwari
Head, Corporate Partnership, Sightsavers India

Sayanti Bit
Assistant Manager, Corporate Partnership, Sightsavers India