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Strategic issues in preventing cataract blindness in developing countries

Ellwein, L B
Kupfer, C
1995

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Cataract blindness is a public health problem of major proportions in developing countries. Intracapsular cataract extraction with aphakic spectacles has been the standard surgical technique for restoring sight. Because of image magnification in the operated eye, however, the result in unilaterally blind patients is less than satisfactory. Fortunately, with the availability of low-cost intraocular lenses ( IOL) and ophthalmologists trained in extracapsular surgery, it is now practical to intervene successfully in the unilateral case. The need for increased attention on the quality of the visual outcome is only one of three important strategic issues in cataract blindness control. The existing high prevalence of cataract blindness in developing countries and an increasing cataract incidence due to an aging population require substantial increases in surgical volume. The third issue relates to cost. If significant increases in surgical volume and quality of outcomes are to be realised without an increased need for external funding, service delivery must be made more efficient. The expansion of IOL surgery for unilateral blindness is a favourable trend in ensuring financial sustainability of delivery systems; patients can be operated on while still economically productive and able to pay rather than waiting for bilateral blindness and a less favourable economic and social impact. It the quality, volume, and cost issues are to be successfully addressed, operational and structural changes to eye care delivery systems are necessary. These changes can be effected through training, technology introduction, management of facilities, social marketing, organizational partnerships, and evaluation. With improved understanding of the critical factors in successful models their widespread replication will be facilitated.

Population and health infoshare

POPULATION REFERENCE BUREAU

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Population and Health InfoShare is an electronic library of material submitted by over 100 partner organisations. It features documents in reproductive and child health, HIV/AIDS, population and related areas. The primary objectives of PH InfoShare are to increase access to important population and health information; provide a means for organisations to share and exchange information; and foster greater dissemination of research findings and lessons learned. For users, PH InfoShare affords easy access to population and health material. Users may access documents by visiting the website or by sending requests via e-mail. Additionally, users may subscribe to e-mail updates, specifying the material they want to receive by topic, region, and partner, or can email themselves documents that they have identified through searching the website. The search facility allows users to select a topic, language, region/country and partner organisation from drop-down lists

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