DateInternational Eye Foundation1 Redesign of eye care services using business practices and income...

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Date International Eye Foundation 1 Redesign of eye care services using business practices and income generation to support the poor Review of progress and constraints in three countries – Malawi, Guatemala, Egypt International Eye Foundation International Agency for the Prevention of Blindness Seventh General Assembly Free paper – International Thursday 23, 2004 12:12-12:24 PM

Transcript of DateInternational Eye Foundation1 Redesign of eye care services using business practices and income...

Page 1: DateInternational Eye Foundation1 Redesign of eye care services using business practices and income generation to support the poor Review of progress and.

Date International Eye Foundation 1

Redesign of eye care services using business practices and income

generation to support the poor

Review of progress and constraints in three countries – Malawi, Guatemala, Egypt

International Eye FoundationInternational Agency for the Prevention of Blindness

Seventh General Assembly

Free paper – International

Thursday 23, 2004

12:12-12:24 PM

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Contributors

International Eye FoundationRaheem Rahmathullah

John Barrows

Victoria M. Sheffield

IEF PartnersMoses Chirambo, Malawi

Mariano Yee Melgar, Guatemala

Akef El-Maghraby, Egypt

R.D. Thulasiraj, India

David Green, Consultant

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Guiding Principle

A paradigm shift in the way eye care is delivered using existing resources is critical to meeting the demand of the world’s growing and aging population.

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Approach to Design

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IEF Partners

Malawi Guatemala Egypt

Name

Lions SightFirst Eye Hospital, Lilongwe

Visualiza, Guatemala City

Magrabi Eye Hospital, Cairo

Organization type

Public/Free service eye

unit

Private practice

Private/NGO

Change goalCreate

mechanisms to earn income

Create social enterprise to

subsidize poor

Create NGO side to

subsidize poor

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Improved quality of clinical care = Satisfactory visual outcome

• All hospitals practice ECCE/IOL surgery

• Transition to small incision cataract surgery (SICS)

• Monitor quality of cataract surgical outcome

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Improved quality of service = Patient satisfaction and convenience

• Create service choices for patient self- selection

• Standardize protocols and practices

• Increase staffing• Introduce patient counseling services• Make physical improvements• Improve procurement

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Improved quality of service

• Improve information and reporting systems

• Introduce and test a computerized patient management information system

• Establish or reorganize outreach campaigns

• Establish or reorganize optical services

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Increased efficiency and productivity =

Lower cost & increased output (cataract)

0

1000

2000

3000

4000

5000

6000

2001 2002 2003

Pediatric Cataract Surgery

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Improved Equity = Services for poor & marginalized

Free and Paying Patients 2003

9886

46

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Malawi Guatemala Egypt

Paying Free

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Improved financial sustainability =

Better able to grow & increase services

Malawi

-

20,000

40,000

60,000

80,000

100,000

120,000

2001 2002 2003

Revenue Expenditure

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Improved financial sustainability =

Better able to grow & increase servicesGuatemala

-

50,000

100,000

150,000

200,000

250,000

2002 2003

Revenue Expenditure

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Improved financial sustainability =

Better able to grow & increase services

Egypt

-100,000200,000300,000400,000500,000600,000700,000800,000

2002 2003

Revenue Expenditure

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• Lack of ophthalmologists restrict growth

• Difficulty recruiting and retaining qualified staff

• Need to develop new leaders and change agents

Key Challenges

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Key Challenges

• Need for a culture and commitment to productivity, quality and sustainability

• Need capacity to address multiple organizational and management issues

• Need stakeholder networks, communication and information sharing

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IEF Investment in Partners

• IEF currently has eight partners in seven countries in Africa, Latin America, Middle East and India

• IEF’s investment has been between US$60,000 and US$160,000 per partner over three years.

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Plans for the Future

• Marshal new resources to invest in new partners

• Foster dialogue around strategic issues supporting leadership, organizational development, quality, sustainability

• Develop regional training and demonstration sites that support sustainability initiatives

• Lead dialogue on monitoring and evaluation to measure improvement and accountability

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Thank YouThank You!

International Eye Foundation