Prof. Dr. Deen Mohd. Noorul Huq Director cum Professor, NIO&H & Line Director, National Eye Care

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SITUATION ANALYSIS: EYE CARE IN BANGLADESH Prof. Dr. Deen Mohd. Noorul Huq Director cum Professor, NIO&H & Line Director, National Eye Care

Prevalence of blindness Overall prevalence of blindness 1.53% (30 yrs & above) Disease specific prevalence - Cataract (79.6%), - Refractive error (5.5 to 6 million) - Childhood blindness 0.80 per thousand - Low Vision (0.56%) Source: National Blindness Survey

OBJECTIVE 1. STRENGTHEN ADVOCACY TO INCREASE MEMBER STATES POLITICAL, FINANCIAL AND TECHNICAL COMMITMENT IN ORDER TO ELIMINATE AVOIDABLE BLINDNESS AND VISUAL IMPAIRMENT

BNCB Current Practices Line Director, National Eye Care to look after blindness prevention program Vision 2020 National Advisory Committee Vision 2020 District Committee Observation of World Sight Day Orientation & training of health care providers from community clinic i to specialized hospitals Regular dissemination of eye care messages through Health Education Bureau. MOU signing in presence of Health Minister & Health Advisor Coordination meeting with the Health Minister & Health Advisor

OBJECTIVE 2. DEVELOP AND STRENGTHEN NATIONAL POLICIES, PLANS AND PROGRAMMES FOR EYE HEALTH AND PREVENTION OF BLINDNESS AND VISUAL IMPAIRMENT

Current Practices National Eye Care Plan (Strategic plan for 2011-2016) developed & practicing. SICS guideline Treatment Protocol Examination Protocol Primary Eye Care Manual for Primary Health Care Workers. Guideline for OT & Ward Management for Nurses & Paramedics. Guideline for counseling in Eye Care. Percentage allocation from health budget for eye care 0.10% of development budget (Next Five Years).

OBJECTIVE 3. INCREASE AND EXPAND RESEARCH FOR THE PREVENTION OF BLINDNESS AND VISUAL IMPAIRMENT

Current Practices A part from Bangladesh Medical Research Council & National Institute of Ophthalmology (NIO), Specialized hospitals in their different Fellowship, Masters & PHD programs conducting research on Epidemiological & Socio Economic determinants of blindness which is a continuous process.

OBJECTIVE 4. IMPROVE COORDINATION BETWEEN PARTNERSHIPS AND STAKEHOLDERS AT NATIONAL AND INTERNATIONAL LEVELS FOR THE PREVENTION OF BLINDNESS AND VISUAL IMPAIRMENT

Current Practices Partnership with INGOs, WHO, National NGOs and Private Eye Care Providers. BNCB reconstituted with wider partnership of INGOs, WHO, National NGOs, Private Eye Care Providers and related Stakeholder. Vision 2020 advisory committee consisting of members from all walks of life functioning well. Vision 2020 district committee formed & functioning in 30 districts i t with members from different stratum t of society. Public Private Partnership projects are implemented even at sub district level.

OBJECTIVE 5. MONITOR PROGRESS IN ELIMINATION OF AVOIDABLE BLINDNESS AT NATIONAL, REGIONAL AND GLOBAL LEVELS

Current Practices Standard formats developed and age and gender specific cataract surgery reports are being collected and sent to IAPB and WHO regularly. Cataract surgical outcome monitoring (CSOM) introduced for piloting at institutional level which will be replicated in other centers after successful implementation.

Infrastructure for eye care (tertiary ti care centers, secondary eye facilities, vision i centers, training institutes) 4 tire - Community Clinic: 18000 - Upazila Health Complex: 495 - District & equivalent Hospital: 67 - Medical College & Specialized Hospital: 66

Primary Eye Care Current Practices Orientation PHC workers of Upazila Health Complex and community clinics on Primary Eye Care are going on to integrate community clinics to primary eye care. - Community Clinics: Referral -Upazila Health Complexes (Vision Center): Treatment of simple eye diseases; Refraction; Screening & referral;

HR (Ophthalmologists, Ophthalmic Technicians) Availability of HR -Ophthalmologist : 800 - Mid Level Eye Care Personnel: 2800 No. of Ophthalmologists trained per year - 50

Service Delivery Achievements (April 2010 March 2011) Cataract Surgery Rate : 1172 per million. Refractive Services : 32 district hospitals & 5 Vision Centre at sub districts level Diabetic Retinopathy : Screening gprogram initiated in 3 districts. Childhood eye care : Services available in 16 centers. Model child eye care centers will be establish in 4 district hospitals as per recommendation of evaluation of BCCC (Bangladesh Childhood Cataract Campaign). Annual Child cataract surgery 2000 per year. Low Vision : 12 centers established most of them are under utilized due to lack of proper referral & un-availability of low vision devices.

Thanks for your kind attention