Technical Analysis of Past and Current Program Approaches and Innovations

The review aimed to summarize the strengths, weaknesses, and lessons learned from the former projects, as well as assess the grant-making process and associated monitoring and evaluation. A total of 41 child blindness projects were funded under AED's A2Z program, with reports available for 27 of those projects. The projects were implemented in 24 countries, with India receiving the most grants (6). The grant amounts ranged from $23,750 to $323,395, and the project durations varied from 9 months to 55 months. The analysis of the reports revealed several key findings. First, projects that had a sustainable infrastructure and partnerships that provided the missing services for the applicant's project were more successful. This is in line with the Continuum of Care theme introduced under the latest CBP program, which emphasizes the importance of a linked chain of services from identifying a child with an eye problem to referral for further examination, treatment, or surgery, and follow-up. In terms of training, the analysis showed that training a few key teachers rather than all teachers in the entire school creates buy-in, dedication, and better follow-up by the teachers in ensuring that children access exams, treatment, and follow-up. This approach was found to be more cost-effective and resulted in more children being correctly screened and followed up. Regarding screening, the analysis noted that many projects had weak referral systems, which should not be an issue in the current CBP program as strong referral systems are required as part of the evaluation criteria. One-off screening projects that hired and trained staff to conduct screening were found to be unsustainable, as personnel tend to leave for other jobs once the project is over. Additionally, constant changing of staff requires continuous training and impacts training costs. The analysis also highlighted the importance of monitoring, which was a surprise coming from a major international NGO. The project noted that monitoring was crucial to ensure that the project was on track and that any issues were addressed promptly. In terms of screening young children and infants, the analysis suggested that it would be better to screen them by an optometrist or refractionist, as they are more equipped to handle the complexity of their eye problems. Overall, the analysis of the reports provided valuable insights into the strengths, weaknesses, and lessons learned from the former CBP projects. The findings highlighted the importance of a sustainable infrastructure, partnerships, and strong referral systems, as well as the need for effective training and monitoring. The Continuum of Care theme was found to be a crucial aspect of the CBP program, and projects that had a comprehensive approach to eye care, including training, screening, and treatment, were more successful. The analysis also emphasized the importance of monitoring and evaluation, as well as the need for strong partnerships and infrastructure to ensure the sustainability of the projects. The report concluded that the CBP program should focus on funding projects that have a comprehensive approach to eye care, including training, screening, and treatment, and that have a sustainable infrastructure and partnerships. The program should also prioritize projects that have strong referral systems and effective monitoring and evaluation mechanisms in place. The report provided a summary table of the projects, including the grant amounts, project durations, and countries where the projects were implemented. The table showed that the majority of the projects were implemented in India, followed by Malawi, Tanzania, and Uganda. The report also included a list of acronyms used in the document, which included AED, CBP, IDP, IEF, KCCO, KI, LOI, M&E, NGO, PGRD, RFA, ROP, TA, TAG, and USAID. The report was prepared by Partners for Global Research and Development, LLC (PGRD) for review by the United States Agency for International Development (USAID). The report was submitted by Victoria M. Sheffield, who served as the lead author and is the President & CEO of the International Eye Foundation and a member of USAID CBP's Technical Advisory Group (TAG). The report was reviewed by Dr. Ralph Helmsen, PhD, who conducted an initial review of the available reports and noted the achievements, challenges, and key highlights.