1. © Sightsavers IAPB 9 GA Primary eye care 2020 & beyond Hannah Faal

2. © Sightsavers Summary  Trends  Demography transition  Population transition  Epidemiological transition  Population development phases and stages  Extent of primary care  The meeting point

3. © Sightsavers Trends 1978Primary health care 1999Vision 2020: The Right to Sight 2007The PEC working group formation 2008PHC: Now more than ever 2008, the reforms 2012Universal health coverage: health as a right Change over time ? VISION 2020, any level of sight as a right VISION 2020: elimination of avoidable blindness.  elimination of avoidable visual disability

4. © Sightsavers Globally –  Primary eye care for the two extremes: aged and ageing and the premature Demography transition  an ageing population  survival of the premature

5. © Sightsavers Population transition  Urbanisation Rural PEC Urban PEC suited to the urban structure Rapid pace of change Urban poverty Lack of the traditional supportive network  Increasing engagement with social determinants of health

6. © Sightsavers Epidemiological transition  The urgency and benefits of integrated programmes and a holistic approach Elimination of communicable causes of visual loss Eye NCDs: cataract, RE, presbyopia, glaucoma, ARMD etc Non – Eye NCDs: Diabetes Non – Eye NCDs: Diabetes Primary care and ocular morbidity- increasing awareness

7. © Sightsavers Population development phases and stages The people/population functions as stewards, consumers, providers, financers of health Their performance and needs in each phase and stage of the population’s development  e.g: Health promotion: adaptation and changes in content and strategy to match ceh_11_25_004_f01

8. © Sightsavers Population development phases and stages Into every home takes on a different meaning in each phase and stage rural area by health worker, use of a poster The TV The mobile phone The internet  Customisation of PEC to suit function and phase/stage.

9. © Sightsavers Extent of primary care With increasing development and awareness of a population on the one hand With the increase in life time diseases and chronicity  Eye health in primary care will need to adapt and integrate with these changes What is offered: the extent of care Who offers it: Task shifting/sharing Self care: self check for diseases Nature of function of front line health facilities: e.g. screening, maintenance management of chronic diseases.

10. © Sightsavers The meeting point Primary care is the coalescing point of the interaction of health and every other business: Social determinants All institutions, organisations whose primary intent is not health but whose decisions, actions impact on health All institutions, organisations whose primary intent is health– health systems Today, Eye health knows eye health business Eye health needs to know every other business Primary care is where eye health is made everybody’s business. Now to 2020 and beyond.