1. Hearing and Vision Integration at the Primary level July 2014 Peter Ackland, CEO. IAPB

2. <10% of people who need eye care utilize eye screening camps

3. Vision Centres

4. Staffing 1 Technician 1 Coordinator 1 Eye Health Field Worker Infrastructure Refraction Cubicle Slit Lamp Computer, Web cam Satellite Connectivity with Base Hospital Optical dispensing unit Autoclave Generator Services Offered Preliminary Examination Refraction Urine/Blood Test Blood Pressure Consultation with Ophthalmologist through Video – Telemedicine Eye health education through Counseling Glasses & Medicines dispensing services

5. Primary Ear and Hearing Care pilot project Dr Shroff’s Charity Eye Hospital, Sound Hearing 2030 & CBM Two Vision Centres in Mustafabad (Delhi) and Rajgarh (Rajasthan) Vision Centre Technicians – 3 months training in ear and hearing (WHO intermediate module for PEHC workers) Provision of essential equipment (Otoscope, Bull’s lamp, Head Mirror, Tuning fork, syringe cannula, kidney tray and boiler) Community sensitisation – ear health awareness materials + combined ear and eye screening camps Very positive evaluation - integration at primary level is possible but some concerns about scalability.

6. Nepal Netra Jyoti Sangh Biratnagar Eye Hospital, Biratnagar 12,416 Ear patients examined 201 Ear surgeries 222,457 Eye patients examined 52,979 Eye surgeries 67 joint eye and ear camps conducted

7. Nepal Netra Jyoti Sangh Programme Development 2014 Ophthalmic assistants receiving training in ear problems. Six District Eye Care Centres started to provide ear care services. Future Ophthalmic Assistants in all remote areas to be trained. ENT surgeon to be deployed in 5 tertiary level eye hospitals.

8. IMPACT e.g. Lifeline Express India Zanzibar Outreach Programme

9. School Programmes FRESH (Focusing Resources on Effective School Health) Vision and Hearing Thematic Indicators included in the Monitoring and Evaluation Guidance for School Health Programs Global Partnership for Education EFAVI Campaign - ICEVI Disability was a big issue at the recent GPE funding replenishment conference

10. Barriers to integrating ears with eyes: Attitudes & silo working From an eye care providers view: the need to invest in many other aspects – technology, training & skills development, supply chain of drugs and hearing aid, referral links, etc.

11. E Evidence A Awareness, Advocacy, Attitude R Resources – financial + information S Sharing, Showcasing, Stamina, Scaling