1. DateInternational Eye Foundation1 Redesign of eye care services using business practices and income generation to support the poor Review of progress and constraints in three countries – Malawi, Guatemala, Egypt International Eye Foundation International Agency for the Prevention of Blindness Seventh General Assembly Free paper – International Thursday 23, 2004 12:12-12:24 PM

2. DateInternational Eye Foundation2 Contributors International Eye Foundation Raheem Rahmathullah John Barrows Victoria M. Sheffield IEF Partners Moses Chirambo, Malawi Mariano Yee Melgar, Guatemala Akef El-Maghraby, Egypt R.D. Thulasiraj, India David Green, Consultant

3. DateInternational Eye Foundation3 Guiding Principle A paradigm shift in the way eye care is delivered using existing resources is critical to meeting the demand of the world’s growing and aging population.

4. DateInternational Eye Foundation4 Approach to Design

5. DateInternational Eye Foundation5 IEF Partners MalawiGuatemalaEgypt Name Lions SightFirst Eye Hospital, Lilongwe Visualiza, Guatemala City Magrabi Eye Hospital, Cairo Organization type Public/Free service eye unit Private practice Private/NGO Change goal Create mechanisms to earn income Create social enterprise to subsidize poor Create NGO side to subsidize poor

6. DateInternational Eye Foundation6 Improved quality of clinical care = Satisfactory visual outcome All hospitals practice ECCE/IOL surgery Transition to small incision cataract surgery (SICS) Monitor quality of cataract surgical outcome

7. DateInternational Eye Foundation7 Improved quality of service = Patient satisfaction and convenience Create service choices for patient self- selection Standardize protocols and practices Increase staffing Introduce patient counseling services Make physical improvements Improve procurement

8. DateInternational Eye Foundation8 Improved quality of service Improve information and reporting systems Introduce and test a computerized patient management information system Establish or reorganize outreach campaigns Establish or reorganize optical services

9. DateInternational Eye Foundation9 Increased efficiency and productivity = Lower cost & increased output (cataract)

10. DateInternational Eye Foundation10 Improved Equity = Services for poor & marginalized

11. DateInternational Eye Foundation11 Improved financial sustainability = Better able to grow & increase services

12. DateInternational Eye Foundation12 Improved financial sustainability = Better able to grow & increase services

13. DateInternational Eye Foundation13 Improved financial sustainability = Better able to grow & increase services

14. DateInternational Eye Foundation14 Lack of ophthalmologists restrict growth Difficulty recruiting and retaining qualified staff Need to develop new leaders and change agents Key Challenges

15. DateInternational Eye Foundation15 Key Challenges Need for a culture and commitment to productivity, quality and sustainability Need capacity to address multiple organizational and management issues Need stakeholder networks, communication and information sharing

16. DateInternational Eye Foundation16 IEF Investment in Partners IEF currently has eight partners in seven countries in Africa, Latin America, Middle East and India IEF’s investment has been between US$60,000 and US$160,000 per partner over three years.

17. DateInternational Eye Foundation17 Plans for the Future Marshal new resources to invest in new partners Foster dialogue around strategic issues supporting leadership, organizational development, quality, sustainability Develop regional training and demonstration sites that support sustainability initiatives Lead dialogue on monitoring and evaluation to measure improvement and accountability

18. DateInternational Eye Foundation18 Thank You Thank You! International Eye Foundation