To End Extreme Poverty, We Must Also End Blindness: Strategies For Case Finding In North Eastern Region Of India Along Banks Of Brahmaputra River?

To end extreme poverty, we must also end blindness: Strategies for case finding in North Eastern region of India along banks of Brahmaputra river? India having the population of 1.4 billion, has  the largest number of individuals suffering from visual impairment and blindness in the world

Recent surveys indicate that due to lack of awareness and resources, it  prevents more than 80% of people from seeking eye care services, that suggests the need to develop cost-effective case finding strategies and bring them for the treatment. We assessed total costs involved and cost-effectiveness of multiple diffienrnt strategies to identify people and encourage to initiate corrective eye services.

Using financial, logistics and administrative data from Drishti Netralaya. Eye hospital retrospectively , we conducted a retrospective micro-costing analysis of case finding strategies that was carried out in last 2 financial years. Finding covered a population of over 2,00,000 people, out of which majority were screened and identified by community camps at villages, door to door survey, school screening of children, screening at local hospitals with primary care. For four different interventions, we estimated total provider costs, costs attributable to case finding and costs for treatment initiation for cataracts. We also estimated costs of teleophthalmology capability within vision center. Estimates were calculated from provided data .

Case finding and treatment initiation costs are lowest for eye camps by community screening and door-to-door screening.  Door-to-door screening is as cost-effective for identifying and encouraging surgery for cataract surgery. The annualized cost of operating a vision center, excluding procurement of spectacles, was estimated. Adding teleophthalmology capability increases outcomes to certain extent, but cost to a large extent. Vision centers were able to reach substantially more patients than any other strategy. 

Policy makers are expected to consider cost-effective case finding strategies when budgeting for eye health in India. Screening camps and vision centers are the most cost-effective strategies for identifying and encouraging individuals to undertake corrective eye services, with vision centers likely to be most cost-effective at greater scale. Investment in eye health continues to be very cost-effective in India.