CHEF International, Khyber Pakhtunkhwa, Pakistan.
Eye (Lond). 2011 Apr;25(4):415-24. doi: 10.1038/eye.2010.186. Epub 2011 Jan 21.
Pakistan, like many other developing countries, is caught in the vicious cycle of poverty, illiteracy, violence, and disease. Right from its inception, it has been facing serious challenges of fast growing population, longevity, unemployment, wars, floods, double burden of diseases including blindness, as well as earthquakes, insurgencies, and political instability. Despite such challenges, the country has managed to reduce the burden of blindness from 1.78% in 1987-88 to 0.9% in 2003.This paper will highlight the methods used to achieve such a difficult goal.
The country used the report of the World Health Organization (WHO) temporary consultant as the initial tool for advocacy to obtain political and professional commitment. Results from the first National Blindness Survey 1987-1990 were used as baseline for development of the programme. Under the Ministry of Health, national and provincial committees with respective coordinators were constituted. To ensure access and equity, the national programme was developed on the basis of district comprehensive eye care services. The concept was carefully tested in a laboratory and then piloted in a real district before it was rolled over to the country. Strong national institutes for human resource development, research and development, and service delivery were established. A strong network of high-quality national institutes was set up and run by powerful national non-governmental organizations. The second National Blindness Survey evaluated the achievements of the programme in 2001-2003.
National prevalence of blindness was reduced by 100% by improving the uptake of services at the district level, especially by females.
与许多其他发展中国家一样，巴基斯坦陷入了贫困、文盲、暴力和疾病的恶性循环。从一开始，它就面临着人口快速增长、长寿、失业、战争、洪水、包括失明在内的双重疾病负担以及地震、叛乱和政治不稳定等严重挑战。尽管面临这些挑战，该国还是设法将失明负担从 1987-88 年的 1.78%降至 2003 年的 0.9%。本文将重点介绍实现这一艰巨目标所采用的方法。
该国利用世界卫生组织（WHO）临时顾问的报告作为最初的宣传工具，以获得政治和专业承诺。1987-1990 年第一次全国盲症调查的结果被用作制定该计划的基线。在卫生部的领导下，成立了国家和省级委员会，分别设立了协调员。为了确保可及性和平等性，国家方案是在地区综合眼保健服务的基础上制定的。该理念在实验室中经过仔细测试，然后在实际地区试点，然后再推广到全国。建立了强大的国家人力资源开发、研发和服务提供机构。建立了一个强大的高质量国家机构网络，由强大的国家非政府组织运营。第二次全国盲症调查评估了该计划在 2001-2003 年的成就。
通过提高地区一级服务的利用率，特别是女性的利用率，全国失明患病率降低了 100%。
