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HomemistoryStrengthening Optometry Education in Developing Nations

Strengthening Optometry Education in Developing Nations

Optometry teachers in developing nations – home to 90 per cent of the world’s visually impaired – are being empowered to enhance the quality of eye care education in their own countries, thanks to an initiative implemented by the Australian eye care community. The program aims to build education systems that will enable developing countries to produce their own, locally trained eye care professionals.

Recent studies fromglobal authorities such as the World Health Organisation (WHO), revealing the extent of unnecessary eye disease in poorer nations, have staggered the global eye care community and triggered initiatives such as Vision 2020: The Right to Sight, which are aimed at eliminating preventable vision impairment.

Global forums have prioritised the need for sufficient qualified eye care personnel to deliver services to communities where none existed or were beyond the financial reach of people. Furthermore, they’ve determined that to create permanent eye care systems, optometric services should be taught in developing nations.

Luigi Bilotto, Director of Global Human Resource Development for the International Centre for Eyecare Education (ICEE), says igniting growth in optometric capacity in developing communities is precisely what’s required to build the eye care services necessary to treat vision impairment.

“If you want to build a sustainable eye care system you need well-trained people and you need infrastructure, and in order to create those human resources you need a locally available way of educating people,” he said. “You not only need skilled and qualified personnel to deliver services to patients but also skilled and qualified educators, to help build optometry and other eye care education systems.

“Countries like Australia have really good opportunities in faculty development programs for continuing education but in other countries these are often unattainable for optometric educators.”

Addressing the Shortage

The stark contrast in ratios of optometry practitioners and educators to population between Australia and many developing countries illustrates the point. Australia has five optometry schools and about 3,500 registered optometrists for its 22 million people. India, with a population of more than a billion people, currently has approximately 9,000 four-year trained optometrists and 40,000 two-year trained optometry personnel.5 It is estimated India needs about 100 optometry schools and to produce about 5,000 optometrists each year to create the 115,000 practitioners required to adequately service its population.3

“You can see that countries such as India face enormous challenges. While optometry education institutions exist there, many more are needed. Additionally, India needs to implement a regulatory system and achieve government recognition as an accredited profession,” says Mr. Bilotto. “Another example is Vietnam, which has a population of around 90 million people, but is still to establish its first optometry course. Then you look at China – with an estimated 600 million myopes alone there is a huge need for optometry capacity.”

Linking Teachers Across Nations

A program hosted by ICEE in Sydney during July aimed to develop the skills of optometry educators in developing nations.

A total of 22 optometry teachers from institutions in China, Ethiopia, India, Vietnam and Pakistan were brought together through the Australian Agency for International Development (AusAID) Australian Leadership Awards (ALA) Fellowships program. The ALA Fellowships were offered under the Australia Awards by AusAID, which aims to promote knowledge, education links and enduring ties between Australia and a new generation of global leaders.

“There’s a lot of work to do for the profession to grow in these countries but we are making progress and programs like this play a part in generating that change. In fact Vietnam will soon establish its first optometry course – which will be a great achievement,” said Mr. Bilotto.

He said optometry educators who attended the ALA Fellowships program will be able to mentor other faculty members, drive the development of optometry standards for both optometric education and patient care, and advocate for optometry to take up the public health challenge of avoidable blindness and visual impairment.

“Every organisation with faculty that attended the program is currently running, or setting up an optometry school,” said Mr. Bilotto. “They have expressed a strong desire for faculty development programs, and are supporting this opportunity for their staff to develop their skills further and improve their faculty on return.”

The program in July incorporated lectures, workshops and practical sessions across a range of topics to improve teaching skills, including training in classroom and clinical teaching and improving assessment skills of optometric educators.

“We brought the faculty from different regions together to enable them to develop networks and to develop the skills of teachers, clinicians and researchers,” said Mr. Bilotto.

A variety of people with different skill levels and qualifications attended. “We had fellows in their first year of teaching, through to those with more than 20 years experience, so there was a range of teaching skills among the faculty. Our aim was to integrate better teaching, build research skills and enhance curriculum development through instruction on course design. In doing so, we hope to create a better quality of optometry programs at the schools which will contribute to a higher level of graduates, and ultimately benefit their communities.”

Our aim was to integrate better teaching, build research skills and enhance curriculum development through instruction on course design

Optometry Moving Ahead in Vietnam

Mr. Bilotto said several fellows attended from countries like India and Vietnam. “The advantage of that, especially for say India – which sent along five people from different universities – is we’ve been able to help create peer support within these countries. This will enhance their capacity to build healthy optometry education institutions.”

He added: “We’re currently working in Vietnam and involved in helping set up an optometry course, with support and funding from the Australian Government, and that’s why a number of fellows from there were in attendance.”

Once this is completed, it is envisaged that the fellows will form the first faculty of optometry in Vietnam. “Although the candidates already had strong leadership and teaching skills, the fellowship further developed those skills and provided an opportunity to network and play a key leadership role. This will be important, not only for the faculty of optometry, but indeed the profession of optometry in Vietnam as a whole,” said Mr. Bilotto.

Public Health Important

The program included topics like cultural experiences in delivering education, gender and disability in optometry and public health optometry. Mr. Bilotto said the public health component was particularly important. “We instilled an understanding and awareness of the role that optometrists and optometry educators can play in building and delivering services to people struggling with blindness and vision impairment who are unable to access or afford optometric care,” he said.

“While practitioners have long been engaged in public health optometry it’s only fairly recently been recognised that this dimension should be included in optometry training courses. By building this into curriculums we can promote opportunities for practitioners to extend beyond the traditional private practice-based path. We also envisage this ultimately pushing the public health agenda further which is an important advance from an advocacy perspective in many developing communities.”

According to WHO estimates:

About 80 per cent of all visual impairment is preventable, treatable or curable; 90 per cent of people with visual impairment live in developing nations.1

Landmark studies2,3,4 have revealed that many millions of children and adults are unnecessarily missing out on education and employment opportunities and can be at greater risk of morbidity.

The ALA Fellowships program was supported by funding from AusAID, ICEE and the Brien Holden Vision Institute. 

Stephen Davis is the Communications Manager at the Brien Holden Vision Institute. Stephanie Looi is the Manager of Global Service Development at the International Centre for Eyecare Education.

References

1. World Health Organization, Visual impairment and blindness Fact Sheet No. 282, October 2011. Accessed at: www.who.int/mediacentre/factsheets/fs282/en/index.html

2. Resnikoff S, Pascolini D, Mariotti SP, Pokharel GP, ‘Global magnitude of visual impairment caused by uncorrected refractive errors in 2004’, Bulletin of the World Health Organization, January 2008, 86(1).

3. Holden BA, Fricke TR, May Ho S, Wong R, Schlenther G, Cronje S, Burnett A, Papas E, Naidoo KS, Frick KD, ‘Global vision impairment due to uncorrected presbyopia’, Archives of Ophthalmology, Vol 126 (No. 12), Dec 2008.

4. Smith TST, Frick KD, Holden BA, Fricke TR, Naidoo KS, ‘Potential lost productivity resulting from the global burden of uncorrected refractive error’ in Bulletin of the World Health Organization, 2009; 87.

5. Delhi Declaration on Optometry andBlindness Prevention in India. Accessed at:www.indianoptometryfederation.org/attachments/delhideclaration.pdf

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