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Improving Optometry Services in Africa

June 25, 2015

Professor Kovin Naidoo. 
Two papers were recently published in international journals, co-authored by UKZN Associate Professor Kovin Naidoo, documenting strides he has made to improve eye-care services in Africa. 
The first paper appeared in the American Academy of Optometry’s Optometry and Vision Science Journal, reporting on factors affecting the academic performance of Optometry students in Mozambique. 

According to Naidoo,  recently named a B-rated Scientist by the National Research Foundation, prior to 2008 there were only four countries in sub-Saharan Africa which had Optometry programmes. 

It was through the Brien Holden Vision Institute and African Vision Research Institute (AVRI) at UKZN that he started the process to initiate schools of Optometry in Africa. 

The first of Naidoo’s programmes was in Malawi. ‘In 2006 Irish Aid announced a research grant of 1.5 million euros for a research programme that would address development challenges in Africa. Given that we had just started the programme in Malawi and  were not sure which approach was the best for Africa, I came up with the idea to submit a proposal to implement and evaluate a school of Optometry in Mozambique so that this study could inform further efforts on the continent,’ Naidoo said.  

‘The Mozambique Eyecare Project is a Higher Education partnership for the development, implementation, and evaluation of a model of Optometry training at UniLúrio. There are many composite elements to the development of sustainable eye health structures and appropriate education for eye health workers remains a key determinant of successful eye care development. However, from the first intake of 16 students, only nine graduated from the programme, whereas just six graduated from the second intake of 24 students. This low graduation rate is attributable to a combination of substandard academic performance and student dropout.’ 

Analysis of data from the interviews and questionnaires during the study revealed four dominant themes that were viewed as important determinants of student refraction competencies: student learning context, teaching context, clinic conditions and assessment, and the existing operating health care context. The results were combined to understand the complexities surrounding the Optometry student training and performance. 

Such evaluation has helped the University and course partners to better structure the teaching and adapt the learning environments by recommending a preparatory year and a review of the curriculum and clinic structure, implementing more transparent entry requirements, increasing awareness of the programme, and improving Internet infrastructure. 

The second study evaluated the visual profile of students in integrated schools in Malawi. 

The researchers felt that blindness and visual impairment were very common in African countries and often loosely linked to inadequate resources. The study was designed to assess clinical visual and ocular characteristics of children in three integrated schools in Malawi so that students needing low vision services or those with correctable refractive error would be identified. 

A total of 95 students underwent a detailed optometric examination where the assessment included distance visual acuity measurement in logMAR notation, near visual acuity, oculo-motor assessment, pupillary assessment,anterior as well as posterior segment evaluation, and non-cycloplegic refraction in all the participants. 

The study found that nine out of ten students in three integrated schools in Malawi had visual impairment and 41 percent had low vision. Inappropriate placement in the integrated schools and poor spectacle compliance were very common and it was concluded that well accepted optical and non-optical devices could improve visual performance in visually disabled children, for which public awareness and parental education was important. 

Naidoo said: ‘When I joined the University, I was very enthusiastic about contributing to the development of eye care. Working with Professor Holden from Australia I established the International Centre for Eye Care Education (Africa) Trust now called the Brien Holden Vision Institute to expand eye care services in Africa. Even though we set up some successful eye clinics I realised that the lack of human resources would always limit our capacity to work with governments to establish eye care services particularly in the public sector. I became very passionate about expanding Optometry schools and we have been involved in doing so in countries such as Malawi, Mozambique, Eritrea, Uganda, Gambia, Cameroon, Guyana, Vietnam and now we are working on doing so in Haiti.’ 

Naidoo said education could not function in a vacuum hence Academics needed to use their intellectual knowledge to advance the interests of society and to address key challenges. This is why he was passionate about public health and eye care. 

'We are particularly proud of this programme. Even though we have an Irish partner this solution and approach was conceptualised before the approach to the Irish institution.

‘Historically, Optometry has been confined to the private sector but this is changing and there's greater access to eye care for our people on the continent. This needs to be expanded so that eye care services become available to everyone everywhere,’ he said.

Lunga Memela

Uploaded by: Fhumulani Andrew Liabara

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