Assam focuses on vision correction

Five years ago, primary school teacher Mr Mohan Rongpeh began struggling to read the blackboard. The world around him was progressively appearing blurry for over a decade, but he accepted the vision changes as a part of ageing that he could do little about. But now that his failing eyesight was affecting his ability to teach, he became stressed about losing his job.

Mr Rongpeh didn’t seek help because he did not want to worry his wife, Ms Sunduki Tarang, who weaves beautiful traditional patterns on fabric. Little did he know that she, too, was embarrassed to tell him about her failing vision.

The couple are not alone. Uncorrected refractive errors are a leading cause vision impairment across all ages. In India, over half the population experiences some form of visual impairment related to refractive errors. A pair of prescription spectacles is all it takes to fix it.

Ms Jamina Rongchong getting her vision tested under the supervision of Dr Harsha Bhattacharjee, president, Sri Sankaradeva Nethralaya, Guwahati, and Accredited Social Eye Care Activist Ms Kanchan Roy (Photo: Sanchita Sharma / © WHO India)

Yet, globally, only 36% of people with a distance refractive error (myopia) have access to appropriate spectacles, while more than 800 million people have near vision impairment (presbyopia) that can be remedied with reading spectacles. This lack of access to cost-effective spectacles not just impairs quality of life but also leads to vision-related productivity losses estimated at $411 billion annually.

To address the unmet need to provide quality, affordable and people-centred refractive error services, World Health Organization, in compliance to the World Health Assembly Resolution (74/12), has launched SPECS 2030. The global target is to increase effective coverage of refractive error by 40% by 2030.

The WHO SPECS 2030 initiative was launched in India in Guwahati, Assam, at a National Health Mission Assam-led strategic planning workshop attended by key stakeholders – education, social justice, health research and healthcare (public, private and NGOs) sectors – and the Ministry of Health and Family Welfare, and WHO. WHO is assisting the Government of Assam in the phased roll-out of SPECS 2030, beginning with demonstrating the feasibility and effectiveness of its implementation in diverse healthcare infrastructure settings. The participants identified actions for establishing scalable models for saturating refractive care services in Assam.

The Assamese module of WHO online Training on Assistive Products (TAP) for use by health workers was launched

One such model is Guwahati-based Sri Sankaradeva Nethralaya’s (SSDN) community-focused initiative for vision care that provides comprehensive screening at the doorstep in rural and remote areas, free spectacles to correct refractive errors, and referral for treatment/ surgery. The initiative benefited Mr Rongpeh and Ms Tarang, who were tested by Accredited Social Eye Care Activists (ASECA) from SSDN in their home in Sonapur village in the Kamrup Metropolitan district in the outskirts of Guwahati and given free spectacles to correct their refractive error.

Another beneficiary is Mr Moni Ram Ingti, a basket-weaver in Sonapur who became a proud owner of prescription spectacles a week ago. “I was doing fine without my glasses, now I am doing better. My brother tried my spectacles and he could also see better. Now he wants his own pair,” said Mr Ingti.

Low demand because of lack of awareness are key challenges to comprehensive vision care, along with poor integration of vision and eye care services in noncommunicable diseases services, paucity of human resources, high out-of-pocket costs, and poor data systems.

Mr Moni Ram Ingti weaving a basket wearing brand new spectacles provided to him a week ago by Accredited Social Eye Care Activists Ms Kanchan Roy (extreme left) and Ms Monalisa Rangpee (right) from Sri Sankaradeva Nethralaya, Guwahati (Photo: Sanchita Sharma / © WHO India)

The Assam SPECS initiative is aiming to change this. “The state government is committed to creating an ‘Assam model’ that can be adapted and implemented at scale in diverse settings. We’ll begin with conducting a needs assessment and set specific targets, including establishing and upgrading infrastructure, strengthening human resources for eye care services, establish efficient and cost-effective procurement systems for uninterrupted supply of spectacles, and using an IT-based reporting system to track service utilization, data management, programme monitoring, and evaluation for real-time course correction,” said Dr Lakshmanan S., mission director, NHM, Assam.

“India has the potential to become a global leader in refractive error correction through the provision of quality, affordable vision correction to empowering individuals and communities to reach their full potential. Constructive collaboration between government agencies, healthcare providers, NGOs, and the private sector can help create a robust and sustainable model for SPECS implementation, one that can be replicated across India and beyond,” said Dr Roderico H. Ofrin, WHO Representative to India.