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Blindness Prevention Programme (BPP)

BLINDNESS PREVENTION PROGRAMME (BPP)
The Lagos State Blindness Prevention Program was started in the year 2000 during the administration of Governor, Bola Ahmed Tinubu as a result of the high prevalence of preventable blinding eye diseases in our society.
At that time, blindness prevalence rate extrapolated from studies done in South West Nigeria indicated a prevalence rate of about 1.0% -1.5% compared to a prevalence rate of 0.2 – 0.3% in most developed countries.

The high prevalence of blindness in the country resulted in the creation of the National Programme for the Prevention of Blindness (NPPB) by the Federal Ministry of Health. The aim of this intervention was to reduce the country’s blindness prevalence rate to about 0.5% in most communities in the country.

The need to compliment this initiative led to the establishment of the Lagos State Blindness Prevention Programme (LSBPP) in the year 2000 with the goal of eliminating avoidable blindness due to diseases such as cataract, glaucoma, refractive errors, childhood blindness in Lagos State. The objective of this initiative is to reduce the blindness prevalence in Lagos State from 1.1% – 1.2% to 0.5% over a five year period.

The initial policy focus of the programme was to reach the people in all the then the 20 local government areas of the State with the main strategy being outreach screening programs and surgical expeditions thereby bringing succor to the less privileged who could not ordinarily afford the cost of orthodox treatment and in so doing alleviating poverty in the society.

In order to further enhance the program and strengthen the delivery of eye care in the State, in 2008 an action plan was articulated to develop a comprehensive eye health care system in the State at all levels. This action plan was based on the findings of a situation analysis of eye care services delivery in the State. This plan is to ensure the long term sustainability of the program and improve efficiency of existing eye care services. For this purpose the programme has been redesigned to have two components:-
(a) Outreach Programs and
(b) Eye health system development.
OUTREACH PROGRAMMES
– Community outreaches which commenced from 2000 till date.
– School Screening commenced in 2006
The activities under the outreach programmes include:-
– Free Eye Screening.
– Provision of Free Eye Medication.
– Provision of free Eye Glasses.
– Free Surgical Intervention.
– Distribution of patient’s information leaflets with emphasis on preventable blinding diseases in English and Yoruba.
– Medical Mission since 2006
– Mini Mission since 2008

EYE HEALTH SYSTEM DEVELOPMENT
1. Integration of Primary Eye Care into Primary health Care Services in Lagos State.
This was achieved by training 30 Medical Officers of health and 167 Primary Eye Care workers who are currently working in the 141 Primary Eye Care Units all over the State. Till date a total of 177 PHCs have pry eye care and IEC materials. These Primary Health Care Units are fully equipped to offer primary eye care services.
The services offered are:-
– Vision screening on continuous basis.
– Early detection of blinding eye conditions.
– Eye Health Education.
– Free treatment of common eye condition such as conjunctivitis now available at the Primary Health Care Units.
– Prompt referral of more difficult cases and those requiring surgery to designated Secondary Eye Unit.
2. Standardization/Equipping of 8 Designated Secondary Eye Units (Vision 2020)
This has been achieved by mapping of Lagos State to delineate catchment areas to be served by each of these designated eye units. The aim is to provide secondary eye care services for 1 million to 1.5 million people through each of the Units. In order to achieve these, the available eye care staffs in the State have been redistributed to cover the designated eight units.

These Units offer medical and surgical services for common eye conditions e.g. cataract, glaucoma, Pterygium and ocular injuries. All of the units are manned by trained personnel.
These Units are:-
– General Hospital Lagos
– General Hospital Epe
– General Hospital Gbagada.
– General Hospital Ikorodu
– General Hospital OrileAgege.
– General Hospital Isolo.
– General Hospital Ajeromi.
– General Hospital Badagry
These eye units have been standardized and equipped such that all services required for investigations, medical and surgical treatment of common blinding conditions can be accessed from each of the Units.
At the tertiary level, government has developed an Eye Institute in Lagos State University Teaching Hospital (LASUTH) Ikeja and equipped it with an ultramodern ophthalmic equipment to meet the increasing demand for eye care delivery in the state. In addition a Corneal Eye Bank within the Institute is being developed in collaboration with the Nigerian Society for the Blind and Ophthalmological Society of Nigeria.

ACHIEVEMENTS
3. Till April 2011, the Programme has covered most of the LGA and LCDAs in Lagos State and reached out to over 334,055 people in various communities in the State. Of those screened, 129,445 have benefited from free eye glasses while 25,781 people have had free eye surgery done to restore their vision.
The program has increased the awareness of the populace on blinding eye diseases and the importance of appropriate treatment for eye ailment. Statistics from medical records have similarly shown that new patient registration attendance to the orthodox eye clinic has risen from4,000 to 10,000 per annum in our orthodox eye clinics. Cataract surgical rate has risen from less than 5/million/year to more than 150/million/year.
4. Full integration of primary eye care into primary health care services in Lagos State through training of Medical Officers of Health (30) and 167 Primary Eye Care Workers.
5. Equipping/standardization of the 8 designated Secondary Eye Units in the State.

SCHOOL SCREENING
The International Agency for the Prevention of Blindness, an agency of the World Health Organization, through the strategy of Vision 2020: the Right to Sight, in 2004, focused on childhood blindness and refractive error as causes of avoidable blindness worldwide. Many cases of irreversible blindness in adult would have been prevented if such cases were detected early at childhood. Also many school drop outs are as a result of undetected refractive errors among school children.
In response to this, the School Eye Health Screening programme which was launched in year 2006 as one of the ways of reducing the burden of childhood blindness as a cause of avoidable blindness in Lagos State. After the initial screening of selected Primary Schools in 2006, a State policy was put in place to continue to screen pupils in Lagos State covering all the LGAs/LCDAs. This has continued till date. From inception till date April 2011, a total of 44,805 pupils were screened different Local Government Areas of the State.

JANUARY – APRIL 2011 ACTIVITY REPORT.
Alausa Staff Eye Clinic. Routine eye screening was carried on daily basis at the staff Eye clinic for Lagos State staff and those requesting for medical assistance. In addition glasses and eye medication were given.
– Total patient seen = 488
– Given Glasses = 281
– Special Order= 103
Amuwo Odofin Low Vision Center.
Routine primary Eye Care Services conducted daily.
– Total patient seen = 478.
– Given Glasses = 242
– Referred = 194
Community Eye Screening:
Free eye screening was carried out during Eko Free Health Medical Missions and various organizations in different part of Lagos State on request.
Eko Medical Mission
– Total patient seen = 10,899
– Given Glasses= 7,015
– Special order= 1,093
Request Screening
– Total patient seen= 652
– Given Glasses = 495
School Eye Screening.
School eye screenings were carried out at various school sin 5 Local Government Areas viz Ikeja, Oshodi, Apapa ,Shomolu and Lagos Mainland.
– Total patient seen= 10,667
– Given Glasses= 138
– Special order=69
World Glaucoma Day
World Glaucoma Day was celebrated on the 11th of March 2011, with a press conference at Ministry of Health Conference room, Alausa. There was distribution of IEC materials.

Primary Eye Care Unit
– A total of 177 PHCs with Primary Eye Care centers were visited and monitored.
– Total patient seen = 4,902
– A total no of 14 vision corridor was installed in 5 Local Governments Area of the State in collaboration with Save a Sight Foundation by the Optometrist.
In line with the objective of this programme to prevent avoidable blindness in Lagos State, series of screening excercise were carried out on request as well School Free Eye Screening.
Conduct Community and School Free Eye Screening- 6 screening venues-idi-Araba,RCCG Ijeshatedo,Goshen Parish
• Total patients seen= 2933
• Given Glasses=1177
• Special Order Glasses=64

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