Assessement Of The Extent To Which The Vision 2020 Eye Care Service Delivery Targets Had Been Met In Burundi By 2015

Abstract

Purpose: To conduct a situation analysis of the implementation of VISION 2020 “The Right to Sight” global initiative in Burundi. Methods: This was a descriptive cross-sectional study targeting District, Regional, and National Hospitals in Burundi. Structured questionnaires were used to collect data on number and distribution of different cadres of eye personnel, infrastructure and equipment, Cataract surgical rate achieved one year prior to the study, availability of coordination, structure and membership of a prevention of blindness committee, eye training programmes and access to eye care services. Data were compiled in 7 ophthalmic regions. The recommendations of Vision 2020 were used to benchmark resources as meeting, exceeding or not meeting targets. Results: There was a National committee for Prevention of Blindness in place in Burundi even though it was operating on outdated strategic plan of 2006-2011 and managed to meet only once in 2011,2013 and2014 and no meeting in 2012 and 2015. Burundi had not met any of the Vision 2020 targets for human resources. The country had achieved the following: 37.5% of the target for Ophthalmologists, 66.0% for Ophthalmic Clinical Officers and 5.1% for Optometrists. The mean deficit for all cadres was 72.8%. Out of the 15 ophthalmologists in Burundi, 80% were based in Bujumbura with 4 out of 7 regions having no ophthalmologist at all. Sixty eight percent of eye care facilities belonged to private sector and 75% were in urban areas. The Cataract Surgical Rate for 2015 was 138. The ratio of ophthalmologists who performed cataract surgery to those who did not was 1:3.75. All the centres well equipped to offer refractive services whereas there were only two centres equipped with laser for management of diabetic retinopathy and three centres equipped with Visual fields for follow up of glaucoma patients. Conclusions: Burundi had not met the targets for human resources by 2015. Most of eye care services were concentrated in the capital Bujumbura leaving most of other areas grossly underserved. Most of eye care activities were offered by the private sector. Only refractive services were available in most centres with inadequate equipment for management of diabetic retinopathy and glaucoma. The CSR was low and most ophthalmologists were not performing cataract surgery.