Bangladesh has made significant strides in healthcare over the past decades, but eye health remains a pressing issue that requires a focused and strategic approach. As we move towards the goal of Universal Eye Health Coverage by 2030, it is imperative to address the existing gaps and strengthen partnerships between the government, INGOs, NGOs, and eye care institutions. Having worked with an international organisation focused on eye health, we have witnessed first-hand the critical need for greater awareness and action in this area.
Eye health is a crucial yet often neglected aspect of overall healthcare in Bangladesh. According to the World Health Organization (WHO), over 750,000 adults in Bangladesh are blind, with a higher prevalence of blindness in women (1.72 per cent) than in men (1.06 per cent). The majority of these cases are preventable or treatable with timely intervention. However, a lack of awareness, accessibility, and affordability of eye care services continues to exacerbate the problem.
Despite the efforts of various stakeholders, including the government, INGOs, and NGOs, to provide eye care services, a significant portion of the population remains underserved. The challenges are multifaceted—from the shortage of trained eye care professionals and the lack of infrastructure in rural areas, to the high cost of treatment and widespread ignorance about the importance of regular eye check-ups. Moreover, eye care has not been integrated as an essential component of the health service package.
The Need for a National Eye Care Plan: Every five years, the health sector introduces a five-year National Eye Care Operational Plan, which is a significant initiative from the Ministry of Health and Family Welfare (MOH&FW). However, the plan and budget are limited in terms of strengthening health systems to deliver eye care for all, with the goal of achieving universal eye health coverage by 2030.
Although the government’s NEC Operational Plan mentions the importance of engagement, contributions, and effective coordination and collaboration with I/NGOs and eye hospitals, the strategies and actions are not clearly defined. Given that there are over 10 INGOs, more than 50 national/local NGOs/CBOs, and over 300 eye hospitals/clinics providing eye care services at various levels, these contributions are significant but often unaccounted for due to the absence of a comprehensive “National Eye Care Plan.” This point was highlighted by Professor Dr AHM Enayet Hussain, Chair of the IAPB SEA Bangladesh Chapter, during a workshop hosted by the NGO Affairs Bureau on 8 July this year.
The National Eye Care Plan should be inclusive, strategic, and aligned with global objectives to achieve Universal Eye Health Coverage by 2030. It should focus on:
• Increasing accessibility. The plan needs to ensure that quality eye care services are accessible to all, especially in rural and remote areas. This includes setting up primary eye care centres that incorporate tele-consultation services with base hospitals.
• Ensuring inclusive eye care. Deprived populations, such as workers in tea gardens, garment factories, the transport sector, ethnic groups, and displaced individuals, are often excluded from the regular health system and cannot access quality eye care. Special programmes targeting these groups are needed to ensure they are informed about eye health and the availability of services.
• Special coverage for the poor. To increase access to eye care services for the poor, the government should introduce a “Demand-Side Financing/Voucher Scheme” for the treatment of major eye diseases.
• Building capacity. Training and deploying more eye care professionals, including ophthalmologists, optometrists, and eye health workers, are essential. Continuous professional development is also necessary to keep them updated on the latest advancements in eye care.
• Raising awareness. Nationwide awareness campaigns are required to educate the public about the importance of eye health, the risks of neglect, and the availability of services. The media should also be engaged effectively to reach broader audiences.
Proposed Steps to Strengthen GO-INGO/NGO-Hospital Partnerships: The success of any national eye care initiative depends on the strength of partnerships between the government, INGOs, NGOs, and eye care institutions like the National Institute of Ophthalmology and Hospital (NIO&H). Establishing a multi-stakeholder platform for joint planning, where the government, INGOs, development and health NGOs, and eye hospitals can come together to set common goals, align strategies, and coordinate efforts, can play a vital role. This platform could also serve as a forum for sharing best practices, resources, and lessons learned.
The National Eye Care Plan needs to decentralise and develop district-level inclusive, comprehensive eye care plans, led by district authorities and supported by I/NGOs and eye hospital partners. According to this plan, support must be provided at the district level, including trained ophthalmologists and ophthalmic nurses, to ensure that district hospitals are functional and capable of delivering secondary-level eye care and referral services. This presents an opportunity for the NEC to compile a National Eye Care Plan that reflects the contributions of both the government and I/NGOs/eye hospitals in Bangladesh’s eye health sub-sector. This plan would bring key players under one umbrella, allowing an effective accountability system to function.
The government, in collaboration with INGOs and NGOs, should explore innovative financing mechanisms, including public-private partnerships, to fund eye health programmes. Additionally, international donors and development partners should be engaged to support these initiatives.
Expectations from the Interim Government: The interim government must demonstrate a strong commitment to improving eye health. This includes prioritising eye health in the national health agenda, allocating adequate resources, and ensuring that eye care services are integrated into the broader healthcare system.
To strengthen the existing system and make it more dynamic, the government, NGOs, and the private sector need to work collaboratively in a coordinated manner. Immediate tasks include revising the scope of work for the BNCB, establishing national and district-level eye health task forces with representation from the government, NGOs, and civil society, and decentralising the NEC plan to the district level. Additionally, developing an accountability system and monitoring mechanism with the involvement of I/NGOs and eye hospital representatives is essential.
Dr Munir Ahmed is the Country Director and Sahos Mostafiz is Communication, Media & Advocacy Specialist at Orbis International
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