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Chapter 2 Situation analysis - Where are we now?

2.1 How to assess needs. What problems are we facing?
   

The first step in the planning process is the assessment of the total magnitude of blindness and low vision in the country or district, the identification of the main causes of blindness, and the assessment of their magnitude. Such data can be available from population-based blindness surveys (the best option), or from Rapid Assessments of Cataract Surgical Services (RACSS),Trachoma Rapid Assessments, Rapid Epidemiological Assessments for Onchocerciasis, etc. (second option).

Check with all partners providing eye-care services to determine what data they have. Always check whether these data were collected using standardized population-based survey methodology and whether the findings are current or outdated. If data are not available or no longer valid, population-based surveys can be undertaken - provided adequate resources are available. Under “Software”, two links refer to manuals and software packages to conduct such surveys.

When no reliable data are available and new surveys are not an option, the magnitude of blindness and its various causes can be estimated by selecting a neighbouring country with a similar socioeconomic situation and health-care system, and using their data (third option). The last (fourth) option is to estimate the magnitude of blindness either through extrapolation from a reference table or the world blindness prevalence map, provided as a link. Select the region in which your country is located and use the prevalence estimates of that region. It is appropriate to review data on all major causes of blindness (Figure 7).

Fig. 7. Global causes of bilateral blindness

Fig. 7. Global causes of bilateral blindness

When appropriate blindness data for the area are collected, these can be entered in a specially-designed spreadsheet (“Templates”: planning spreadsheet, worksheet: “Needs”). The spreadsheet will help to calculate the caseload for total blindness and the various causes of blindness in the area.

Some indicators for the situation analysis, such as the cataract surgical coverage and the proportion of successful cataract operations, can only be obtained through population-based surveys or specially-designed management information systems.

Checklist

  • Collect prevalence and number of persons who are blind and visually impaired in the area, using appropriate levels of visual acuity.
  • Assess causes of blindness: prevalence and numbers affected.
  • If not available, consider conducting survey or rapid assessment.
   

Documents

link: Acrobat documentWHO - Available data on blindness (1987)

link: Acrobat documentWHO Available data on blindness (1994)

link: Acrobat documentWHO - Global data on blindness - an update

DocumentsEstimate needs by extrapolation from reference table

link: Acrobat documentWorld blindness prevalence map

link: Acrobat documentConsultation on development of standards for characterization of visual loss and visual functioning

link: Acrobat documentDifferent measurement systems for visual acuity

Web sites

link: Web siteWHO Prevention of Blindness and Deafness

Templates

link: Excel documentPlanning spreadsheet

Documents WHO/PBL Eye Examination Record

link: Acrobat documentCoding instructions for the WHO Eye Examination Record Form

Software

link: Document Rapid Assessment of Cataract Surgical Services (RACSS)
 

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