By Elias Hakizimana.
Rwanda International Institute of Ophthalmology (RIIO) in partnership with the Ministry of Health (MoH) will soon establish strong health care facilities at all health centres countrywide. The initiative will be funded by Fondazione Leonardo Del Vecchio during the 10 year-strategic plan with the MoH.
The initiative will involve school eye health screening and eye tests at all health centres where primary eye care will be offered to reduce blindness and visual impairment in Rwanda.
Speaking during a one-day workshop organized by RIIO last week in Bugesera District, Dr John Nkurikiye, Associate Professor of Ophthalmology at Rwanda International Institute of Ophthalmology (RIIO) said that the initiative is in line with the implementation of the national strategic plan for eye health implemented by directors of health in the district.
The workshop gathered all Directors of Provincial and Districts’ Hospitals as well as Directors of Health across the country.
“We wanted the district hospitals and directors of health in districts who are the implementers of the programme to be on the same page with us so that we can all have ownership of the programme, so, we wanted to talk about the three topics: primary eye care, school eye screening and Performance-Based Financing (PBF) so that we can give adequate services to our communities,” said Nkurikiye.
He said that accommodating primary health care at health centres will involve trained nurses at health centers will examine, treat and refer patients who have eye problems.
Rwanda was the first country to implement the nationwide eye health care programme (primary eye care) since 2012 (8 years now).
Dr Nkurikiye said that “we are now 8 years after the beginning of the programme , we want to enhance the trainings of nurses to make them more efficient, some have moved on and we want to train more and to do a refresher for those who have been trained, so, it is important to give services to the communities near their homes, that is where the health centres come in,” he noted.
Among the challenges that are still impeding eye care include lack of enough nurses for eye care as they are overwhelmed with other tasks within the multi-health discipline tasks at health centers. Some are working in HIV, Malaria, reducing malnutrition. Eye care is a new package that is being added to others. Another challenge is the journey of patients who are referred to districts’ hospitals.
To achieve the programme, combined efforts from Ministry of Health, Directors of hospitals, district authorities, ophthalmologists and other professionals as well as the communities have a role to play.
He said that every patient in need of care should have access to care starting from the health system at the bottom all the way to the hospitals. “there is no condition that cannot be treated in Rwanda, that is an achievement.” He said.
Dr Pascal Ngiruwonsanga, Director of Gako Hospital in Gisagara District, Southern Province said that they receive 325 patients with eye problems every year in their location of five health centres and among them a big number are children under 15 years’ old who suffer from allergic conjunctivitis while mature people between 30 and 45-year-old suffer from reflective errors.
He said that one hindrance is that many people are not aware of eye care service decentralization at health centres. “We expect a big number of people to be treated and we are going to reach out all schools to mobilize children to be tested.
In common, according to Dr John Nkurikiye, elderly people and children are the most vulnerable of eye problems.
Only in Gisagara District, eye diseases come at 10th place after Malaria, women diseases, dental and oral diseases, and more.
Dr Rose Baguma, Director General of Education policy, planning and school health in the Ministry of Education said that when the health of a student affects the performance in education and human capital when they finish their schools.
“last year, we approved the special needs and inclusive education policy. When we talk about inclusive education and special needs people will always think about disabilities, but also visual impairment is one of the things that are mentioned there and that affects a lot the achievements of our education goals, So, this comes as a response not fully covering all the problems we have in education, but part of it can help us implement this policy. We are happy for this and we pledge our contribution for whatever is needed as the Ministry of Education so that we can help our children learn and achieve the learning goals,” she said.
Thierry Amimu Mungwakuzwe, Project Manager of Fondazione Leonardo Del Vecchio-Rwanda that supports the eye care programme implementation said that there will be a screening of children in primary one and secondary one every year to make sure the primary eye care is delivered in 10 years later.
Through primary eye care programme, 16 schools were screened in Gasabo district, 3 schools in Bugesera, more than 24 Thousand children were screened.
Worldwide, an estimated 19 million children are visually impaired, of which 12 million are due to uncorrected refractive error; 1.1 million children worldwide are irreversibly blind.
Up to 60% of children die within a year of going blind. Three-quarters of vision-impaired and blind children live in the poorest regions of Asia and Africa, most lacking access to treatment.
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