Pereira Sara M, Blignault Ilse, du Toit Renee, Ramke Jacqueline
The Fred Hollows Foundation New Zealand, Auckland, New Zealand.
Rural Remote Health. 2012;12:2095. Epub 2012 Sep 18.
Delivering eye health services to people in rural areas, especially in fragile, post-conflict countries, is a major challenge. This article reports on the implementation and evaluation of an innovative district-based outreach service. The main project partners were the Timor-Leste Ministry of Health and an international non-government organization, with assistance from a local non-government organization.
An eye care nurse in Covalima District, a remote location 178 km from Timor-Leste's capital, Dili, was provided with a motor-bike for transport and regular support for outreach eye services to sub-district facilities. Data collected over the first year of operation were examined and included: services provided, spectacles dispensed, health promotion activities conducted and the cost of providing these. The project was also evaluated for its relevance, effectiveness, efficiency, impact and sustainability.
In the first 12 months, 55 outreach visits were conducted across the district's seven sub-districts during which 1405 people received vision screening, and 777 spectacles were dispensed. In addition to meeting the five evaluation criteria, compared with the hospital-based eye clinic the outreach service resulted in significantly greater gender equity among eye health service beneficiaries. This pilot project demonstrates what can be achieved when a Ministry of Health (central and district level) and non-government organizations (international and local) work in partnership to support a dedicated health care provider.
为农村地区的人们，尤其是脆弱的冲突后国家的人们提供眼保健服务是一项重大挑战。本文报告了一项基于地区的创新外展服务的实施和评估情况。主要项目合作伙伴是东帝汶卫生部和一个国际非政府组织，并得到了一个当地非政府组织的协助。
在距离东帝汶首都帝力178公里的偏远地区科瓦利马区，一名眼保健护士获得了一辆摩托车用于交通，并获得了对向分区设施提供外展眼保健服务的定期支持。对运营第一年收集的数据进行了审查，包括：提供的服务、分发的眼镜、开展的健康促进活动以及提供这些服务的成本。还对该项目的相关性、有效性、效率、影响和可持续性进行了评估。
在最初的12个月里，在该地区的7个分区进行了55次外展访问，期间有1405人接受了视力筛查，分发了777副眼镜。除了符合五项评估标准外，与医院眼科诊所相比，外展服务在眼保健服务受益者中实现了更大程度的性别平等。这个试点项目展示了卫生部（中央和地区层面）和非政府组织（国际和当地）合作支持一名专注的医疗服务提供者时所能取得的成果。
