Primary Eye Care Trends to 2020 & Beyond: A Summary by Hannah Faal

1. IAPB 9 GA Primary eye care 2020 & beyond • Hannah Faal

2. Summary • Trends • Demography transition • Population transition • Epidemiological transition • Population development phases and stages • Extent of primary care • The meeting point

3. Trends Change over time ? VISION 2020, any level of sight as a right VISION 2020: elimination of avoidable blindness. elimination of avoidable visual disability

4. Demography transition • Globally – • Primary eye care for the two extremes: aged and ageing and the premature an ageing population  survival of the premature

5. Population transition Urbanisation Rural PEC • Urban PEC suited to the urban structure • Rapid pace of change • Urban poverty • Lack of the traditional supportive network • Increasing engagement with social determinants of health

6. Epidemiological transition Elimination of communicable causes of visual loss Eye NCDs: cataract, RE, presbyopia, glaucoma, ARMD etc Non – Eye NCDs: Diabetes Primary care and ocular morbidity-increasing awareness The urgency and benefits of integrated programmes and a holistic approach

7. Population development phases and stages The people/population functions as stewards, consumers, providers, financers of health Their performance and needs in each phase and stage of the population’s development e.g: Health promotion: adaptation and changes in content and strategy to match ceh_11_25_004_f01

8. Population development phases and stages • Into every home takes on a different meaning in each phase and stage • rural area by health worker, use of a poster • The TV • The mobile phone • The internet • Customisation of PEC to suit function and phase/stage.

9. Extent of primary care • With increasing development and awareness of a population on the one hand • With the increase in life time diseases and chronicity •  Eye health in primary care will need to adapt and integrate with these changes • What is offered: the extent of care • Who offers it: Task shifting/sharing • Self care: self check for diseases • Nature of function of front line health facilities: e.g. screening, maintenance management of chronic diseases.

10. The meeting point • Primary care is the coalescing point of the interaction of health and every other business: • Social determinants • All institutions, organisations whose primary intent is not health but whose decisions, actions impact on health • All institutions, organisations whose primary intent is health– health systems • Today, Eye health knows eye health business • Eye health needs to know every other business • Primary care is where eye health is made everybody’s business. • Now to 2020 and beyond.