The need for Advocacy & Promoting Eye Health in India

1. The need for Advocacy & Promoting Eye Health in India Thulasiraj Ravilla LAICO – Aravind Eye Care System

2. Why Advocacy Plan ≠ Performance Money ≠ Resources Resources ≠ Results Ideas ≠ Action

3. Any program to succeed needs .. • Resources – Finance • Resources – Program input • Right policies • Enabling environment • Right Structure & Governance • Partners in implementation • These don’t fall in place automatically • Advocacy is all about making these happen

4. Advocacy Model Target Group Advocacy & Sensitization Strategies Purpose Desired Outcomes

5. Target Groups • Policy Makers • Funding agency • Providers (eye care professionals) • Enabling agencies (Education departments) • Community • Patient

6. Advocacy Focus - Policy Makers Purpose: • Ensuring that blindness control stays on the agenda of MOH – GOI & State Health Ministries • Financial commitment • Supportive policies • Legislations • Approvals Strategies: • Workshops • Evidence based intervention strategies • Impact assessment • Evidence of money well spent

7. Advocacy Focus - Funding Agencies Purpose: • To mobilize required resources • Budget/expense approvals Strategies: • Workshop on National/State plans • Workshops on project details • Evidence of regular monitoring • Impact assessment

8. Advocacy Focus – Eye Care Providers Purpose: • Alignment • Involvement • Increasing quality/efficiency/coverage Strategies: • Inclusion of Community Ophthalmology (Vision 2020) in the PG curriculum • Sessions in State, National association meetings

9. Advocacy Focus - Enabling Agencies Purpose: • Cooperation • Taking on additional responsibilities Strategies: • Activity Focused Workshops • Legislation/Directives from Policy makers

10. Advocacy Focus - Community Purpose: • Influencing health seeking behaviour • Support of outreach, case finding Strategies: • Health education • Social marketing • Awareness campaigns • Including eye health in school curriculum • State launches of Vision 2020 • Write-up/programmes in popular media

11. Advocacy Focus - Patient Purpose: • Compliance – treatment, follow-up, care Strategies: • Counselling • Disease or treatment specific information

12. Case Study – Examples from India

13. Advocacy for right “Program Structure” • Eye Care coordination committee to be constituted at National level • District Blindness Control Societies (idea piloted and developed by DANPCB-DANIDA) • VISION 2020 – The Right to Sight India: a consortium of non-governmental organizations working in eye care • State Eye Health Societies

14. XI Five Year Plan (2007-12) Request for increased financial allocation from about $ 100 to $ 400 Million (request made in Sep 2006)

15. CATARACT SURGERIES: 1985-2005 World Bank Project Quality: 5% with IOL in 1993 increased to 90% in 2005 Evidence: Funding enhances performance

16. Tenth Plan (2002-07): Target Vs. Achievements Evidence : Have capacity to deliver

17. Tenth Plan Performance:Budget Allocation & Expenditure (Total allocation for 10th Plan was $ 110 Millions) Evidence: Have capacity to absorb funding

18. Major challenges to be addressed • Reaching the underserved population • Providing Comprehensive Eye Care • Enhancing the quality of Services & monitoring outcomes • Human Resource Development - training all cadres • Developing Sustainable Infrastructure through a public-private partnership for service delivery • Remaining Technologically current in Eye Care • Monitoring the impact - epidemiology of Blindness Rationale: What needs to be done?

19. BUDGET 2007 – 2012 ($ Millions) (Total allocation for 10th Plan was $ 110 Millions) The Pitch: $ 110 M to $ 421 M

20. Ultimate purpose of Advocacy • Improved Eye Care Services • More persons served (prevention, cure and rehabilitation) • Universal coverage • Goals of Vision 2020 met

21. Course Schedule