Date Published: December 8, 2009
Publisher: Public Library of Science
Author(s): Susan Lewallen, Amir Bedri Kello
Abstract: Susan Lewallen and Amir Bedri Kello argue that human resources management will be crucial in reaching the global goal of eliminating avoidable blindness by the year 2020.
Partial Text: Globally, there are 314 million people with vision impairment, of whom 269 million people have low vision and 45 million are blind ,. The geographic distribution of visual impairment is not uniform and more than 90% of the world’s visually impaired live in developing countries. Sub-Saharan Africa, with around 11% of the world’s population, has about 20% of the world’s blindness . This represents the highest regional burden of blindness in the world. VISION 2020: The Right to Sight is a broad initiative whose goal is to eliminate avoidable blindness by the year 2020 (see Box 1). Whether this initiative goes the way of other unrealized slogans of the past, or whether it can actually be met still remains to be seen. In sub-Saharan Africa, there are still vast populations with limited or no access to eye services. Progress has been made in some places, however, and there are lessons we can learn from these that will help us come closer to realizing VISION 2020 goals. In this article, we examine the need for dedicated managers if VISION 2020 goals are to be achieved in Africa.
Inadequate human resources have long been noted among the constraints to better eye health care ; the ophthalmologist-to-population ratio for much of sub-Saharan Africa countries is usually accepted to be around 1∶1,000,000 . Therefore, one of the three prongs of the VISION 2020 strategy is human resource development, including the training of more personnel. This goal usually seems to be interpreted as a need for more personnel with clinical training. While the inadequate numbers of doctors and nurses providing eye care in Africa is indisputable, sheer numbers, either trained or working, should not be the main indicators of progress. What happens after training? Is the training applied effectively? How productive are workers and what factors influence this?
Ideally a hospital that was central to a VISION 2020 program serving 1–2 million people would ensure that there was a manager to work alongside the surgeon head, so that things ran well within the hospital and an outreach service was organized (see Box 2). Indeed, at purely private (mission) hospitals, at least those that are productive, this situation is often in place. But most ministries of health have limited health system managers to spare and often are not willing to provide those they have to eye programs.