African Programme: Kenya

Abstract

Kenya is one of the East African countries with a coastline bordering the Indian Ocean and astride the equator. The country has an area of 225,000 square miles and a population of about 30 million people. The prevalence of blindness is estimated as 0.7%, with cataract contributing 43%, trachoma 19% and glaucoma 9%. The Kenya Ophthalmic Programme (KOP) is a Ministry of Health (MOH) programme receiving administrative support from the Kenya Society for the Blind (KSB). It started as a small project in 1956 but has grown into a major National Programme rendering comprehensive eye care (CEC) through a network of about 70 Government and NGO static and outreach service delivery points scattered all over the country. About half a million patients are treated annually. The KOP priorities are: To make the existing eye units fully operational before building new ones Improve training of all cadres of eye workers Generate income so that services can be sustained Adopt a primary health care approach in prevention of blindness. The KOP falls under the Primary Eye Care Division of the Department of Preventive and Promotive Health of the MOH. In 1966, the Ministry of Health created the National Prevention of Blindness Committee (PBC). The PBC meets quarterly and brings together representatives of all the stakeholders in prevention of blindness. The KOP Secretariat is the technical arm of the PBC and is housed by the Kenya Society for the Blind. The KOP Coordinator heads it. Under the KOP Coordinator there are the Primary Eye Care Manager, the National Eye Health Information Officer and the National Eye Drop Production Unit. In 1993, the Ministry of Health officially recognised Primary Eye Care as an Element of Primary Health Care. Through collaboration with Education and Rehabilitation programmes funded by the KSB and other NGOs like Christian Blind Mission Inter national and Sight Savers International, the KOP is able to offer comprehensive eye services. The country is divided into ten ophthalmic zones each under a Zonal Eye Surgeon (ZES). A zone geo-medical unit has a referral eye unit (Government or NGO). Under the zonal eye unit are the district and mobile eye units. Personnel at the districts includes the Ophthalmic Clinical Officers (OCO), OCO Cataract Surgeons (OCO/CS), Community Health Workers and Outreach Drivers. In the near future the KOP plan to train Ophthalmic Nurses (one year course) who will be in-charge of rendering community eye care services, especially health promotion. Low Vision Therapists' training is being discussed at the Prevention of Blindness Committee. There is a feeling by most of the PBC members that the OCOs and the nurses can render refraction services to avoid creating too many cadres of eye care workers. Short management courses for eye care managers have been recommended. Training of equipment Ophthalmic Technicians is an urgent need. Hospital Maintenance Technicians are not trained to repair / service instruments and equipment.