Rural blindness prevention II (OPG) IEF

Final PES covers the period 3/80-12/83 and consists mainly of the executive summary of an attached special evaluation (XD-AAP-080-A) based on document review, site visits, and interviews. The project, due to end 12/31/83 (a decision made by IEF and USAID/K too abruptly) has had a great impact and achieved its goals. (1) Nine surveys on the prevalence of blindness have been completed; the data are being analyzed for use by the MOH and by other Kenyan and non-Kenyan institutions. (2) Seventeen functioning Mobile Eye Units have been established and have been supported by IEF commodity provision to eye clinics. (3) In education, 51 seminars on primary eye care and blindness prevention were held for 1,765 participants, and effective teaching materials for health personnel were developed and are widely used both inside and outside of Kenya. Also, IEF helped rural health training centers develop a curriculum on primary eye care and blindness prevention. (5) The IEF established one community-based health project and supported another. These projects have unexpectedly increased community awareness of both eye disease and health in general, tapped communuity potential to initiate and plan health projects, and been replicated in other countries. (6) Besides providing therapeutic assistance, two project ophthalmologists taught and supervised, at provincial hospitals, counterparts who will help form an MOH primary eye care prevention education unit. Appointment of a senior MOH official to supervise eye activities and the transformation of the MOH"s Prevention of Blindness Committee into an effective decisionmaking body in 1981/82 facilitated implementation. However, chronic shortages of MOH supplies reduced project effectiveness, and institutionalization - which IEF, despite great efforts, could have hastened by working on it sooner and by integrating more Kenyans into the project - is far from assured. Although the MOH is now committed to preventive health care, it has been slow to establish the primary eye care unit, has stretched its field staff too thin, and has not provided for continuation of preventive work. A concentrated effort by all concerned is needed to keep the program alive; USAID/K should seriously reconsider providing program support for 2 years.