Dr Nicholas Banatvala Symposium 3: Health Systems Development

1. Health System Strengthening and Multi-Sectoral Approaches in the Draft Action Plan for the Prevention ofBlindness and Visual Impairment 2014-2019 Dr Nicholas Banatvala Symposium 3: Health Systems Development IAPB 9th General Assembly, 17-20 September 2012, Hyderabad

3. Successes • Shortcomings • Changing landscape • Key issues emerging

4. Strengthening health systems to reduce the burden of visual impairment • Developing and strengthening national policies, plans and programmes for the prevention of blindness and visual impairment is critical. • There remains the need to even better integrate eye diseases control programmes into wider health care delivery systems, especially within primary health care. • Strengthening comprehensive eye health services and wider health service delivery needs to go hand in hand. E.g. human resources, financial resource allocation, engagement with the private sector… • Good practice exists but needs to be better documented and disseminated. • More work needed on cost-effective tools for scaling up national responses to eye care, especially on the costs of a national comprehensive eye care package that integrates into the wider health system. Advancing multisectoral action • Elimination of avoidable blindness is significantly dependent on the progress of other global health and development agendas, such as the provision of clean water and sanitation. • Where appropriate, eye health should be included into broader noncommunicable and communicable disease frameworks, with the identification of appropriate interventions to contribute to poverty eradication. • Although there are a limited number of proven risk factors for the major causes of blindness, those supported by evidence (e.g. diabetes mellitus, smoking, premature birth, rubella, vitamin A deficiency) need to be addressed where appropriate through multisectoral interventions. • A major challenge will be to see how the vision loss agenda is incorporated into wider health policies and strategies and development (including post-MDG) initiatives.

5. Published on the WHO website 31 August 2012 • Logframe approach • Web-based consultation and formal meeting in Geneva on 8 October • Draft goes to Executive Board in January and then to the WHA in May

6. Universal access to eye health: a global action plan 2014-2019 Vision A world in which no one is needlessly visually impaired, where those with unavoidable vision loss can achieve their full potential and there is universal access to comprehensive eye care services. Goal To reduce blindness and visual impairment as a global public health problem Indicators: magnitude of blindness & severe/moderate VI at global and regionallevels Purpose To improve eye health through comprehensive eye care services integrated in health systems. Indicators: eye care personnel per million population & cataract surgical rate

7. Universal access to eye health: a global action plan 2014-2019 Objective 1 Evidence generated and used to advocate for increased political and financial commitment of Member States for eye health. Objective 2 National policies, plans and programmes for eye health which are integrated into national health systems developed and/or strengthened and being implemented along the lines of the WHO health system building blocks. Objective 3 Multisectoral engagement and effective partnerships for improved eye health strengthened.

9. ACTIONS FOR OBJECTIVE 2 2.1 Provide leadership and governance for developing/updating, implementing and monitoring national/sub-national policies and plans for eye health [within the context of wider national health policies and plans]. 2.2 Secure adequate financial resources to improve eye health and provide comprehensive eye care services integrated into health systems through national policies and plans. 2.3 Develop and maintain a sustainable workforce for the provision of comprehensive eye care services as part of the broader HRH workforce 2.4 Provide comprehensive and equitable eye care services at primary, and secondary and tertiary levels. 2.5 Make essential medicines, diagnostics and health technologies of assured quality with particular focus on vulnerable groups and underserved communities. 2.6 Include indicators for the monitoring of eye care service provision and their quality as part of a national information system.

12. ACTIONS FOR OBJECTIVE 3 3.2 Enhance effective international and national partnerships and alliances 3.3 Integrate eye health into poverty reduction strategies, initiatives and socioeconomic policies

13. Monitoring and evaluating the impact of the plan: indicators and targets

14. Summary • Follow up action plan has been published • Consultation process underway • Goal, purpose and 3 objectives, with actions underpinning each objective • Health systems and multisectoral engagement are central to the plan • Activities for Member State, international partners and WHO Secretariat are integrated into each action • Small but comprehensive set of indicators to monitor the plan