A critical analysis of the South African health policies and programmes with regard to eye health promotion

Abstract

Eye health promotion is an important aspect of VISION 2020 campaign that aims to eliminate unwarranted cases of avoidable blindness worldwide by the year 2020. Most developing countries, including South Africa, have a serious burden of eye diseases and unwarranted causes of visual impairment and blindness. The purpose of this research therefore was to highlight the lack of an integrated eye health promotion policy in the South African primary health care system which can play a major role in the elimination of this burden of disease and also to make proposals for eye health promotion policy development in South Africa. A combination of quantitative and qualitative research methods was used in this study. Questionnaires and interviews were conducted with all national and provincial health managers of portfolios relevant to eye care. Also, various health policy documents were requested from the National and Provincial Department of Health to ascertain claims of any existing guidelines on eye care. The policy documents and guidelines obtained had no specific reference to eye health promotion. Only 11 (23%) of the managers of provincial health directorates reported that they have integrated vision screening in their health promotion programmes as part of eye health promotion strategies. Eye care managers in the provinces reported that school visits accounted for 75% of eye health promotion programmes target areas. Also, apart from the Northern Cape Province which has no eye care manager and consequently no eye health promotion programmes, the Western Cape Province also does not have eye health promotion programmes and relies mostly on private sector for eye care services. The lack of an integrated eye health promotion policy and most probably the lack of a dedicated directorate that deals with eye health promotion issues may be a contributing factor to the overwhelming lack of integrated eye health promotion activities in South Africa. It is therefore recommended that an integrated eye health promotion model be developed and be part of the South African primary health care system.