Evaluation report : International Eye Foundation blindness prevention and health education program

Evaluation covers the period 6/77-7/79 and is based on site visits and interviews with project personnel and trainees, and is attached to a PES facesheet (PD-AAJ-354). Due to the excellent work of the International Eye Foundation (IEF) and Kenya"s Ministry of Heath (MOH), the project has been a success and prompted the MOH to extend eye services to peripheral areas. All five planned rural blindness prevention units (BPU) -- manned by a trained clinical officer (CO) and a driver -- have been established to screen for eye diseases and provide public health education in schools and pre-natal and under-five clinics. Because the CO"s are uniquely competent, they have the people"s confidence, thus stimulating use of eye services. Also, an additional BPU was established in Mombasa; health education and disease prevention capabilities were added to seven existing mobile BPU"s; a general screening and referral service was implemented; high-quality information and teaching charts are ready for distribution to health centers, schools, and the public; and collection of baseline data on eye diseases will be completed by 12/79. Because the three trained Kenyan ophthalmologists have not taken charge of the program, indigenization is not yet feasible and continued IEF support is imperative. Other problems include inadequate transportation for CO"s; an underpaid, overworked staff; non-continuous supply of necessary medicines; lack of appreciation of eye diseases among clinicians; lessened service coverage due to inadequate surveys and analyses; and inadequate diagnostic laboratory procedures. It is recommended that: (1) the project be expanded to include community health care workers and other African countries; (2) nutritional and biochemical data be subjected to epidemiological analysis; (3) drug and staffing needs be prioritized according to eye survey data; (4) surveys of endemic eye diseases be expanded; (5) a surveillance system be created; (6) eye services be integrated into the general health system; (7) ongoing education be provided to CO"s; and (8) district and provincial BPU"s be established.