Allen Foster Research Center for Community Eye Health, International Center for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, India.
Indian J Ophthalmol. 2012 Sep-Oct;60(5):396-400. doi: 10.4103/0301-4738.100533.
Blindness is a major global public health problem and recent estimates from World Health Organization (WHO) showed that in India there were 62 million visually impaired, of whom 8 million are blind. The Andhra Pradesh Eye Disease Study (APEDS) provided a comprehensive estimate for prevalence and causes of blindness for the state of Andhra Pradesh (AP). It also highlighted that uptake of services was also an issue, predominantly among lower socio-economic groups, women, and rural populations. On the basis of this analysis, L V Prasad Eye Institute (LVPEI) developed a pyramidal model of eye care delivery. This article describes the LVPEI eye care delivery model. The article discusses infrastructure development, human resource development, and service delivery (including prevention and promotion) in the context of primary and secondary care service delivery in rural areas. The article also alludes to opportunities for research at these levels of service delivery and the amenability of the evidence generated at these levels of the LVPEI eye health pyramid for advocacy and policy planning. In addition, management issues related to the sustainability of service delivery in rural areas are discussed. The article highlights the key factors required for the success of the LVPEI rural service delivery model and discusses challenges that need to be overcome to replicate the model. The article concludes by noting the potential to convert these challenges into opportunities by integrating certain aspects of the existing healthcare system into the model. Examples include screening of diabetes and diabetic retinopathy in order to promote higher community participation. The results of such integration can serve as evidence for advocacy and policy.
失明是一个全球性的重大公共卫生问题，世界卫生组织（WHO）最近的估计显示，印度有 6200 万视力受损者，其中 800 万失明。安得拉邦眼病研究（APEDS）为安得拉邦（AP）的患病率和失明原因提供了全面估计。它还强调服务的接受度也是一个问题，主要是在社会经济地位较低的群体、妇女和农村人口中。在此分析的基础上，L V Prasad 眼科研究所（LVPEI）开发了一种眼科保健提供的金字塔模型。本文介绍了 LVPEI 的眼科保健提供模式。本文讨论了基础设施发展、人力资源开发以及在农村地区初级和二级保健服务提供背景下的服务提供（包括预防和促进）。本文还提到了在这些服务提供层面进行研究的机会，以及在 LVPEI 眼科健康金字塔的这些层面产生的证据是否适合宣传和政策规划。此外，还讨论了与农村地区服务提供可持续性相关的管理问题。本文强调了 LVPEI 农村服务提供模式成功所需的关键因素，并讨论了需要克服的挑战，以复制该模式。本文最后指出，通过将现有医疗保健系统的某些方面纳入该模型，可以将这些挑战转化为机遇。例如，筛查糖尿病和糖尿病性视网膜病变，以促进更高的社区参与度。这种整合的结果可以作为宣传和政策的证据。
