March 2018

Orbis, has been working in South Africa for 8 years with a clear goal of ensuring eye health for all children.

By Lene Øverland and Kira-Leigh Kuhnert

First published on LinkedIn

To achieve this, we support the development of stronger public health systems so that children can access quality eye health services when they need them.

An Integrated Approach to Health Systems Strengthening

Through our integrated approach, grounded in research, advocacy and capacity development, we support the strengthening of health systems which includes the improvement of human resources. With the right person, with the right skills in the right place, our partners are able to provide quality, age-appropriate eye-health services.

A collaborative initiative between Orbis, Brien Holden Vision Institute (BHVI) and the Dublin Institute of Technology (DIT), generously funded by the Irish Embassy in South Africa, is supporting stronger child eye health systems in South Africa. The goal of this collaboration is to facilitate and support the development of a comprehensive child eye health framework that will secure integrated, age-appropriate eye health services across the life cycle of every child.

Sight impacts every stage of a child’s development. At birth sight enables infants to visually connect with their parents and caregivers. At the age of five sight enables play and social interaction whilst at the age of 15 it gives access to education and future opportunities.

Through collaboration and partnerships with key stakeholders, the three organisations are building on the existing policies and legislation that guide the health of children in South Africa by establishing a national framework that guides effective implementation, ensures capacity-building and the development of national implementation guidelines. The collaboration draws on the strength of multiple role players that are key to the development and implementation of the multiple eye-health services that often reside in different directorates such as Health, Basic Education and Social Development.

Continuum of Services

Vision, as with any other developmental domain, develops across the lifecycle of the child. The provision of age-appropriate services at different ages is key to optimal health and the prevention of blindness. It is hence critical that there is clarity and agreement on the continuum of services, and the effective delivery of these services, across the life cycle of a child. Furthermore, it is essential that services are viewed, delivered and monitored holistically. This holistic approach can only be attained through a shared national child eye health framework that consolidates all essential services across the life cycle.

There are two broad key stages where the development of children’s vision presents opportunities for promoting good eye health, preventing blindness and poor sight and the associated developmental delays: ages 0 to 5, the Early Childhood Development period covered by the Road to Health Booklet (RtHB); and ages 6 to 19, the school going years covered by the Integrated School Health Policy. It is imperative that there is continuity between these two stages with regard to assessments and service provisions. Orbis, Brien Holden Vision Institute and the Dublin Institute of Technology aim, through their collaboration, to support this continuity..

In the first stage, 0 to 5 years, it is well documented that development and learning is achieved through vision. This critical link is recognised in the Road to Health Booklet , under Pillar Two which embeds vision screening into the development monitoring process. The RtHB lists warning signs of poor eye health and urges parents and caregivers to be vigilant and ask for medical support if any problems are detected. The development potential of children can only be achieved if the RtHB is supported by quality vision screening and parenting support. The national child eye health framework will be the vehicle for supporting the strengthening of these services.

An Approach with Impact

BHVI has collaborated, for several years, with government, to strengthen early detection and the provision of remedial eye health services for children of school-going age. BHVI has supported government’s drive to integrate eye health services into national school health programmes. They also provide technical assistance in the development of training programs for school health workers and have supported a project in Soweto for the delivery of spectacles with 32 000 people benefiting from the initiative.

Orbis aims to ensure that our work is an integral part of the under-5 campaign in South Africa and, to this end, supports the strengthening of the package of vision services provided under pillar 2. Furthermore. Orbis is establishing links across the early and school-going years to provide practical insight into the benefits of adopting the life-course approach.

The Power of Partnerships

The Orbis, BHVI and DIT collaboration supports the South African Civil Society Coalition for Women’s, Adolescents’ and Children’s Health (SACSoWACH) early development initiative. We invite interested partners to join us in our collaboration to ensure South Africa’s children reach their full potential.