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BMC Ophthalmology

, 17:96

Cataract and refractive surgery


BackgroundThis study measured the effectiveness and cost of a capacity building intervention in 25 eye hospitals in South Asia, East Africa and Latin America over 4 years. The intervention involved eye care non-governmental organizations or high-performing eye hospitals acting as -mentors- to underperforming eye hospitals-mentees- in 10 countries. Intervention activities included systematic planning and support for training and key equipment purchases as well as hospital-specific mentoring which focused on strengthening leadership, increasing the volume and equity of community outreach, improving surgical quality and volume, strengthening organizational and financial management and streamlining operational processes.

MethodsThis is a before and after observational study of the impact of this multi-dimensional process on hospital and individual productivity and financial sustainability after 4 years. Mentee hospitals reported data monthly using a standardized template. Key indicators included cataract surgery volume, cataract operations per surgeon, the proportion of direct paying cataract surgical patients, intervention program costs per additional surgery and cost per mentor.

ResultsBy the end of the study period, the hospitals experienced a 69% average increase range: −63% to 690% in cataract surgical volume over baseline with 12 hospitals showing increases over 100%. Twenty-three hospitals experienced a 59% average increase in the number of cataract surgeries per surgeon with 10 hospitals showing increases over 100%. The proportion of paying patients increased in 8 of the 14 hospitals reporting this data. The average mentoring cost per additional surgery for these 25 hospitals was $5.39. An average of $36,489.99 was spent per mentor per year to support their work with mentees.

ConclusionsThe intervention resulted in proportionally similar increases in cataract surgical volume and productivity across diverse settings in three distinct geographic regions. Its wide applicability and moderate cost make it an attractive means to rapidly and substantially increase eye care services to meet VISION2020 goals.

KeywordsCapacity building Ophthalmology Africa South Asia Latin America AbbreviationsAECSAravind Eye Care System

CSRCataract surgical rate

CSVCataract surgical volume

KCCOKilimanjaro Centre for Community Ophthalmology

KPIKey performance indicator

LVPEILV Prasad Eye Institute

SNCSadguru Netra Chikitalaya

VMANNNVivekananda Mission Ashram Netra Niramay Niketan

Autor: Katherine Judson - Paul Courtright - Thulsiraj Ravilla - Rohit Khanna - Ken Bassett


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