Primary Eye Care Training Course

Background

Resources and Capacities of Sabatia Eye Hospital

    Human Resources and Facilitators

    Eye Care Service Delivery

    Training Facilities

Entry Criteria

Student Assessment and Exam Grading

Job Description for Primary Eye Care Trainees

Self Evaluation of Sabatia Eye Hospital

Overview of Curriculum

    Current Curriculum of Lectures

Current Fee Structure

 

 

Background

The need for training nurses or Clinical Officers (CO) for three months/ short period of time as low level eye care cadres arises from many factors.  Some of these factors became apparent following the result we obtained in the situational analysis of eye care services in the western province done in collaboration with the Provincial Medical Officer (PMO), District Medical Officer of Health (DMOH) and eye care professionals in the province. This analysis revealed that out of the 8 districts in the province 5 of them do not provide any level of primary or secondary eye care and don't have any level of eye care trained personnel.  The situation may be similar in other provinces and may even be worse in some remote underserved areas/districts.

The Global Vision 2020 initiative was started over 7 years, nearly a third of the time is gone. Much of the desired implementation of the strategy is not being seen on the ground at the community and district levels.

The Primary Eye Care (PEC) services like:

is not being done as much as desired and as fast as possible in line with the National Vision 2020 Strategic Plan of Kenya.

We think providing a short term basic practical and theoretical training to already existing health care professionals like nurses and COs can help and significantly enhance the implementation of those Primary Eye Care services in line with the national 5 years Vision 2020 strategic plan and the bottom up health service delivery action plan of the government. This is the basis for the urgent need of the short term training.  The few number of Ophthalmic Clinical Officers / Cataract Surgeons (OCO/CS), Ophthalmic Nurses (ON) and Ophthalmologists available won't meet this pressing need at the community and district levels.

This understanding and conclusion was reached after thorough discussion with the Provincial Health Officer (PMO) in consultation and with the participation of the Division of Ophthalmic Services (DOS) in the Ministry of Health (MoH) and brainstorming on the issue with DMOHs and eye care professionals and provincial ophthalmologist in workshops organized and hosted by the Hospital.

After this wide range of consultation and discussion with all partners and stakeholders it was agreed that Sabatia Eye Hospital will be a resource centre for this provincial vision 2020 plan whose main objective is to provide primary eye care to the community and contribute in integrating primary eye care to health care services and implement the objectives of vision 2020 in the province.

 

 

The Hospital can provide the following capacities for the training

 

Human Resources and Facilitators

 

Eye Care Service Delivery

The Hospital, being the third largest eye care provider in the country and the largest in Western Kenya, covers a good number of patients in:

Apart from the clinical services we provide Low vision service at the low vision unit and in the community through visits to blind schools. Eye health education and patient counseling is done in the Hospital.

PATIENTS STATISTICS SUMMARY FOR 2003-2006

Sabatia Base Hospital

2003

2004

2005

2006

Patients Seen

14,711

14,897

16,034

17,427

Cataract Operations

1,013

1,668

2,186

2,571

Total Operations

1,576

2,340

2,857

3,216

Mobile/ Outreach Services

Patients Seen

5,764

12,592

13,546

13,401

Cataract Operations

216

451

483

489

Total Operations

267

544

562

553

No. of Mobile Clinic

56

54

72

76

Total Outreach & Base Hospital Services

Patients Seen

20,475

27,489

29,580

30,828

Cataract Operations

1,229

2,119

2,669

3,060

Total Operations

1,843

2,884

3,419

3,769

 

 

Training Facilities

We provide adequate training facilities.

Hostel

Hostel for our trainees

 

 

Entry Criteria

Agreed for the course in our conclusion was to include health professionals from nurses and above like clinical officers. All trainees of our first group were nurses.

 

 

Student Assessment and Exam Grading

1. AVERAGE OF WEEKLY CONTINUOUS ASSESSMENT TEST RESULTS: 30%

2. WARD/CLINIC/THEATRE ASSESSMENT: 10%

3. FINAL QUALIFYING EXAMINATION - TOTAL 60%

       WRITTEN: 30%

       PRACTICAL: 30%

              Short Case: 10%

              Long Case: 20%

4. FINAL SCORE = 1 + 2 + 3 = 30% + 10% + 30% + 30% = 100%

The passing mark is 50%.

The training has a course coordinator (OCO/CS) whose major role is to organize:

Facilitators

The first group of seven nurses completed their training and at the final assessment we were convinced that they can meet the above mentioned objectives if proper support, supervision and space is provided to them at their work station.

Sabatia Eye Hospital Management thinks that this training can provide the necessary and needed low level eye care professionals in the provision of primary eye care. We are engaged in discussion with both KMTC and the DOS in MOH for the recognition of the course at certificate level by KMTC. It will be important for the trainees if the course is accredited and recognized by KMTC. It will also encourage us to strengthen the course and train more.  It may also facilitate a career path and other benefits to the trainees.

 

 

Job description for Primary Eye Care Trainees

After the training the trainees can offer the following basic services:

 

 

Self Evaluation of Sabatia

We started the course without properly assembling teaching materials like handouts, relevant books and other materials. That has at the beginning caused some minor problems to the students.  We have now overcome those problems.

There was a problem from both the trainees and the Nurses/Head of Departments in the areas of assessment and supervision as most trainees being long served nurses were reluctant to be supervised by our staff.

We feel finally the training went well while problems were resolved and improved. Our final assessment was very positive considering most of the trainee's performance at the end of the course both in theoretical and practical skills achieved.

We believe it is necessary to continue to support them through supervision and visits at their work stations on regular basis. We are in touch with them in order to organize a regular visit by our clinicians.

 

 

Curriculum

Detailed topics including the allocated time of the 12-week-course are given on the curriculum below.
Training includes a one and half hour morning lectures from Monday to Thursday and a one hour assessment test on Fridays. Additionally, the students are divided into three groups and assigned to different stations for practial training:

The trainees are given a chance to join our mobile/outreach team.

 

Current curriculum of lectures

The topics are subject to change according to further evaluations.

  Hours Description
 
Basic Science of the Eye
  2 Anatomy of the eye
1 Physiology of the eye / optics
 
Eye Diseases / Pathology
  2 cataract
  2 conjunctival diseases & Allergies
  2 trauma
  2 refractive errors
  1 diseases of the orbit
  1 retinal diseases
  1 diabetic retinopathy
  1 squint & Lacrimal System
  1 low vision / rehabilitation
  1 community based rehabilitation (CBR)
  2 corneal diseases
  2 glaucoma
  2 childhood blindness
  1 Vitamin A Deficiency / Xerophthalmia
  1 Uveitis
  2 Lids and Orbital diseases
  1 Ocular pharmocology
  1 optic nerve
  1 HIV/AIDS and ocular manifestaions
  1 systemic eye diseases
  1 Onchocerciasis / Leprosy
  2 Trachoma
  2 Vision 2020 / Community Ophthalmology
  2 Primary Health Care
 
Problem orientated learning
  1 Sterilization techniques
  1 When to refer an eye patient
  1 red eye
  1 acute onset-Blindnes
  1 gradual onset-Blindnes
 
CAT 8 Continous Assessment Tests

 

 

Current Fee Structure

The basic fee including 12 weeks of full-board accommodation, stationary, tuition and registration among others is 53000 KES per trainee only. On request we can provide a primary eye care equipment consisting of an ophthalmoscope, handheld tonometer, visual acuity chart, trial lens set and a binocular loupe for only 27000 KES. Please note, that the fees are subject to change.

In case of additional questions please don't hesitate to contact us.