Williams Carmel, Szetu John L, Ramke Jacqueline, Palagyi Anna, du Toit Renee, Brian Garry
The Fred Hollows Foundation New Zealand, Auckland, New Zealand.
Clin Exp Ophthalmol. 2008 Mar;36(2):162-7. doi: 10.1111/j.1442-9071.2008.01685.x.
To evaluate against its objectives the achievements of the first 5 years of a national eye health programme in Vanuatu.
Programme clinical activity data were collated from surgical logs, clinic and outreach reports, and patient register books. Cataract surgical outcomes were retrieved from monitoring software. Programme annual reports provided information about management, infrastructure improvements, equipment supplied, repaired or replaced, the supply and use of consumables, and human resource development and deployment. Costs were determined from project budgets and acquittals.
The programme promoted eye health, including through the integration of eye care into existing health services; established adequate facilities, at referral hospitals, provincial hospitals and rural health clinics, with equipment and manpower to provide eye care appropriate to the location; established a primary eye care programme; strengthened cataract services, although its effect on any cataract backlog is unknown; developed a diabetic eye disease diagnosis and treatment service, but its reach and effectiveness are unknown; provided accessible comprehensive eye care, but its effect on the prevalence of vision impairment is unknown; and established medical records and data collection systems, but these need more attention.
This programme achieved much. However, the evaluation highlighted the limitations of inadequate project design and that, without addressing further human resource development and the Ministry of Health's wavering financial commitment, there are potential risks to ongoing services. That revenue generating capacity was not incorporated into this programme may prove to be a flaw that will limit ongoing access to eye care, especially in rural areas.
对照目标评估瓦努阿图国家眼健康计划头5年的成果。
从手术记录、诊所及外展报告以及患者登记簿中整理计划临床活动数据。从监测软件中获取白内障手术结果。计划年度报告提供了有关管理、基础设施改善、所供应、维修或更换的设备、消耗品的供应和使用以及人力资源开发与部署的信息。成本根据项目预算和决算确定。
该计划促进了眼健康，包括通过将眼保健纳入现有卫生服务；在转诊医院、省级医院和农村卫生诊所建立了足够的设施，并配备了设备和人力，以提供适合当地的眼保健服务；建立了初级眼保健计划；加强了白内障服务，尽管其对任何白内障积压情况的影响尚不清楚；开展了糖尿病眼病诊断和治疗服务，但其覆盖范围和效果尚不清楚；提供了可及的全面眼保健服务，但其对视力损害患病率的影响尚不清楚；建立了医疗记录和数据收集系统，但这些需要更多关注。
该计划取得了很大成就。然而，评估突出了项目设计不足的局限性，并且，如果不进一步解决人力资源开发问题以及卫生部摇摆不定的财政承诺，持续服务存在潜在风险。该计划未纳入创收能力可能被证明是一个缺陷，这将限制特别是农村地区持续获得眼保健服务的机会。
