Integrated model of primary and secondary eye care for underserved rural areas: the L V Prasad Eye Institute experience

• Published in: Indian journal of ophthalmology Vol. 60; no. 5; pp. 396 - 400
• Main Authors: Rao, Gullapalli N, Khanna, Rohit C, Athota, Sashi Mohan, Rajshekar, Varda, Rani, Padmaja Kumari
• Format: Journal Article
• Language: English
• Published: India Medknow Publications and Media Pvt. Ltd 01.09.2012; Medknow Publications & Media Pvt. Ltd; Medknow Publications & Media Pvt Ltd; Wolters Kluwer Medknow Publications
• Subjects: Academies and Institutes; Advocacy; Analysis; Avoidable blindness and visual impairment; Blindness; Blindness - epidemiology; Blindness - prevention & control; Community eye health; Comprehensive eye care; Delivery of Health Care, Integrated - organization & administration; Diabetes-related blindness; diabetic retinopathy; disability; educational status; effective service delivery; enabling environment; equity; eye care model; Eyes & eyesight; gender and ethnic groups; Global blindness; health and development; Health care delivery; health economics; health policy; Health services; Humans; impact; income; India - epidemiology; inequality; key informant; Medical research; Medicine, Experimental; ophthalmogical residency; Ophthalmology; Prevalence; Prevalence studies (Epidemiology); prevention of blindness; Primary Health Care - methods; pyramidal model; rapid assessment of avoidable blindness; resources; retinopathy of prematurity; Review; Rural areas; Rural Population; scaling up; Secondary Care - methods; social class; social exclusion; stakeholders; tele-ophthalmology; VISION 2020; visual acuity; Visual impairment; India
• ISSN: 0301-4738; 1998-3689
• 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.