How OPC Fights Blindness in Guinea

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Case Study: Monitoring the Social Impact of OPC’s Comprehensive Eye Care Program in the Republic of Guinea

Eye health is an important part of global health, and greatly impacts global development.

In developing countries, partial or total loss of vision can have major and lasting effects on all aspects of a person’s life, from daily personal activities to interactions with family and community. Education and work opportunities become scarcer or even disappear, and access to public services, often already complicated, becomes even more difficult. 

The impact of a person’s vision loss also affects their family, which must provide care and support, often with limited resources. But it also creates a social and socio-economic ripple effect that is felt beyond the family, at the community, regional and national level.

Combating vision loss and eliminating preventable blindness improves a country’s economy, equality, and development, while also reducing its financial and social burdens.

According to the latest Vision Atlas report from the International Agency for the Prevention of Blindness (IAPB), 90% of vision loss is preventable or treatable. This means that millions of people live with visual impairment or blindness that is not necessary, and that for millions more cases, vision loss is a problem that can be solved if people have access to appropriate treatment and eye health resources. 

Safe, cost-effective and proven solutions to combat vision loss already exist, such as annual eye exams, eyeglasses and cataract operations. These three solutions alone could mitigate the vast majority of vision loss in the world. They are part of the comprehensive and universal eye care projects implemented by OPC. OPC’s projects are comprehensive because more than one disease is addressed, and universal as they promote equal access to care for everyone. This type of project, implemented throughout Francophone Africa, reinforces the health system through capacity building addressing infrastructures, medical equipment, trainings, provision of supplies and sustainability solutions.

Guinea Project Objectives

The main objective of this comprehensive, universal eye care project in Guinea was to fight blindness in three forest regions along the Guinea-Mali border: Kankan, Faranah and N’Zérékoré. Five ophthalmology departments in regional or district hospitals were selected to participate in this program, with the goal to reorganize their infrastructure, outfit them with equipment and supplies and train staff.

Initially planned over a two-year period from 2013 to 2015, the project lasted longer due to the Ebola pandemic that caused a near-complete shutdown of activities from 2014 to 2016.

The evaluation conducted at the end of the project in 2018 concluded that the previously set targets were exceeded and commended the Kankan Regional Reference Hospital team for the quality of the work done across the three regions. They requested a follow up of the five hospitals to provide, if necessary, the elements needed for the uninterrupted continuation of activities and, later on, to improve the management of diabetes and diabetic retinopathy. 

This project was possible thanks to the generosity of OPC’s partner, the International Lions Club Foundation.

Measuring Social Impact

Measuring social impact is a process of understanding how much social change occurred through this program and can be attributed to OPC’s activities. An important aspect is integrating stakeholder voices to understand the community outcome over a long time, which OPC does working closely with local partners to ensure local ownership of eye health care services.

The metrics used to measure social impact for this project included the annual number of patient visits in the ophthalmology departments and the annual number of cataract surgeries performed. 

Consultations: The high attendance in 2014 shows that the quality of care provided is established through upgraded services, and that more patients choose hospitals for eye care rather than private services, which are also more expensive. The three-pronged access to care, confidence and quality of care provided are important to:  

  • Ensure the reputation of eye health services.
  • Sustain hospital services that derive significant revenues from the ophthalmological department.
  • Reduce the portion of the family budget for eye health care.
  • Improve the quality of life of individuals and restore their autonomy with the socio-economic impact that goes hand in hand, translating into improved purchasing power, a more stable family and a developing and enriched community. 

 

Ophthalmology Consultations Follow up Since 2014

 

2013 2014 2015 2016 2017 2018 2019
Kankan 5,350 9,339 8,236 11,049 11,544 15,659 16,800
Siguiri 785 1,850 5,737 6,273 6,788 4,976 3,322
Faranah 572 1,084 1,775 2,207 1,347 2,598
Macenta 495 2,864 3,931 4,813 5,341 3,535 3,001
N’Zérékoré 1,955 1,111 3,347 3,974 4,918 4,844
Total 9,157 14,053 20,099 27,257 29,854 30,435 30,565

 Source: National Ocular Health Program

(*) October 31, 2019

 

Cataract surgeries: This indicator provides information on the number of patients regaining a more comfortable quality of life allowing increased personal and financial autonomy, access to information and public or private services — in short, an improved quality of life that again has a direct impact on the individual, their immediate family and their community. 

 

Cataract Surgeries Follow up Since 2014

2013 2014 2015 2016 2017 2018 2019*
Kankan 1,676 1,646 1,939 2,731 2,260 2,647 2,389
Siguiri 190 826 803 537 493 256
Faranah 57 170 443 9 161
Macenta 1,005 1,537 1,319 1,903 1,877 1,510
N’Zérékoré 1,032 1,111 3,347 3,974 4,918 233
Total 2,708 2,841 4,447 5,247 5,395 5,415 4,549

Source: National Ocular Health Program

(*) October 31, 2019

 

Analysis

The change in the annual number of ophthalmological services provided at the five hospitals is ascending in all cases. This trend confirms that the provision of public eye health care exists in this area of Guinea and that patients are using it with increasing frequency. OPC’s experience has shown that the better the quality of care in an ophthalmological structure, the more patient numbers increase. This is due to two reasons:  

  • Patients are the first to talk about it to those around them.
  • Health professionals who screen patients for eye problems refer them to their colleagues in hospitals because they have better equipment.

Cataract surgery, which is closely linked to quality and visual comfort, also contributes to the increase in consultations for ophthalmological services for the reasons outlined above. If the patient is satisfied with the outcome of their operation, they will talk to their family, loved ones and their community. Word of mouth always has a considerable impact on the number of patients who arrive for consultation. Patients come because they are confident that they are in good hands and that they will receive quality eye care, and the consultation then increases year over year. That is the case with this project.

Overall, the impact of this project on these communities in Guinea is positive. Access to eye health care exists, the quality of care provided allows an increasing evolution of consultations and cataract surgeries, and all of this improves the quality of life of patients.

The program in Guinea shows that through the reinforcement of the eye health system, which included two proven and cost-effective solutions — eye exams and cataract operations — real change is being made in these communities, and that investment in OPC translates to investment in positive change in Francophone Africa and on the global health stage.

 

“I am very happy to be in the city where I can find the facilities to seek care and preventative treatments for me and my child. I heard of Kankan Hospital’s Eye Care Unit because my grandmother recovered her sight there after a successful cataract operation. I am glad such a service is available because Conakry is very far and I don’t have the means to travel. I want to make sure my child’s sight is fine.” – F.H.

 

Help OPC continue to make real change: your support allows us to bring inclusive comprehensive eye health care projects to more people in Francophone Africa.

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Photo caption: F.H. takes her 2-year-old daughter for her first eye exam at Kankan Hospital’s eye care center in Guinea. They live 17 miles away from the hospital.