Family, Child, Adolescent Health (Includes Maternal & Child Health)
Cost Effectiveness of Vision Screenings of School Children Aged 5-15 by Teachers in sub-Saharan Africa
(School of Public Health (UMD) Health Services Administration Master's Student)
Since VISION 2020 was launched in 1999 by the World Health Organization, preventing blindness in children has been a priority for global public health. Approximately 90% of the 1.4 million children worldwide who suffer from blindness are found in developing countries. Out of these 1.4 million blind children, 45% of these cases are caused by avoidable conditions such as strabismus/amblyopia, refractive errors, and vitamin A deficiency (“Childhood Blindness”, 2015). With only 3.7 optometrists and 5.5 allied ophthalmic personnel per million population in sub-Saharan Africa, preventable childhood eye disorders often go un-diagnosed from lack of human resources for eye health (Palmer, 2014). School vision screenings by health professionals in pre-primary and primary school children are minimally implemented in African countries due to resource limitations. Training teachers on screening techniques could effectively allocate eye health personnel to other local eye clinics/hospitals where they are needed more. We developed an input-output model to project the potential cost-effectiveness of school-based vision screenings by teachers in sub-Saharan Africa projected over the next 10 years by examining a few primary inputs: 1) number of potential patients and 2) clinical and cost effectiveness of screening compared with the standard of care. Data for the cost of resources, intervention effects, biological and diagnostic parameters are extracted from published reports, expert opinion, and the WHO-CHOICE database. We use the WHO-CHOICE standardized geographic coverage levels of 50%, 80%, and 95% to evaluate the percentage of eligible cases receiving treatment. However, a possible shortcoming is the lack of specialized training among teachers. Vision screening results are dependent upon the examiner’s training. Despite potential barriers, providing children with an early intervention through their familiar classroom teachers will increase the identification of preventable vision problems, but affordability does comes into question.