A recent research study of OneSight Vision Centers in The Gambia offers new insight into the importance of implementing a strengthening program for services that address poor vision through the lens of a health system.
The study, supported by the Vision Impact Institute and conducted by Brandeis University in coordination with OneSight, examines how local OneSight Vision Centers in the country are increasing access to vision care and creating awareness of uncorrected vision among the local population.
The issue is a significant challenge, as global estimates suggest that 39 million people are blind and 285 million are at risk of severe vision loss, with a significant portion of these in Sub-Saharan Africa.
In The Gambia, according to the International Agency for the Prevention of Blindness (IAPB), only four optometrists served the entire country in 2014, mostly based in urban areas. Evidence also shows that although one in every three Gambians needs refractive error correction, only half of them are aware they even have a vision problem. Additionally, high levels of poverty often deem the cost of eyeglasses to be prohibitive. Against this backdrop, the study highlighted ways in which OneSight and The Gambian government are providing solutions.
These five takeaways stand out from the research:
1. Public-private partnership models can help achieve sustainability.
The vision care centers highlighted in this research are a collaborative effort between The Gambian Government and OneSight, demonstrating how a health system framework can be used to achieve sustainable vision care services.
The partnership is grounded in leadership and governance, such as policymaking and regulation, which then ensures that resources like financing and technology are in place to increase access, awareness, and affordability. One practical key to this is the presence of the OneSight country office which works closely with local governments, health departments, school districts, and ophthalmic partners to equip them to run vision centers in their own communities.
2. Strong local policymaking builds a foundation for success.
In 1987, in response to the WHO’s Vision 2020 declaration to eliminate avoidable blindness, The Gambia launched its National Eye Care Program to reduce blindness and low vision. With that program in place, in 2013, OneSight launched its first vision center in partnership with The Gambia Ministry of Health. In subsequent years, additional centers opened, many in remote areas lacking vision care access points.
The government accepted control of the vision care infrastructure in mid-2019. Since then, regular communication with the Minister of Health continues and all vision care and eyewear services have been maintained.
3. Programmatic coordination must be prioritized.
Numerous teams were required in order to coordinate efforts to create awareness about uncorrected refractive errors, assess the readiness of the population to buy glasses, and analyze their ability to afford them. Coordination between teams, including technical teams, vision center staff, optical leads, marketing, and advocacy, was essential for smooth operations.
A thorough understanding of local needs and available resources also played a role in assessing the population’s readiness. As an example of coordination, the government provided the human capital required to operate the vision centers and was responsible for paying salaries. When new facilities were constructed, OneSight and the government split the costs for the building and construction. OneSight also financed the equipment for vision centers and the overhead costs for the first six months of operation.
4. Empowering and developing human resources is an essential long-term investment.
Investing in human resources is key to sustainability. In vision centers around The Gambia, local staff were trained by OneSight’s expert vision industry leaders who volunteered their time to train Gambians on operations, sales models, and clinical protocols. Post-training, these personnel were distributed across the country, including to rural and remote areas.
5. The burden of financing must be shared.
Financing of vision centers was a partnership and collaboration between OneSight and The Gambia Ministry of Health. While OneSight provided start-up capital for the renovation, equipment, supplies, lenses, frames, and training, once operational, the sales of eyeglasses and other vision products fully covered future operating costs for each vision center.
This research places a spotlight on the power of individual countries, committed to improving the vision of their population, blending local expertise with the technical leadership of organizations in the sector to create new models for delivering care. Collaborations like those in The Gambia and OneSight Vision Centers create crucial investments in a promising future for generations to come, while creating awareness, reducing the prevalence of poor vision and contributing to achieving the UN Sustainable Development Goals.