Introduction: The appropriate education for eye health workers is a key determinant of sustainable eye health care systems, and the solution to avoidable blindness and visual impairment. The Mozambique Eye care Project (MEP), is developing the country's first indigenously trained optometrists using a competency-based education curriculum.

Aims: The principal aim is to evaluate the exit clinical competencies of the first optometry graduates in Mozambique and to inform the evaluation of the competency curriculum.

Methods: Using UK based competencies as a benchmark; nine final year students were examined to assess competences in six core subjects.Further information about factors relating to their performance in these competencies was gained through semi-structured interviews with course developers and lecturers.

Results: All the students were competent at communication, professional conduct and methods of ophthalmic examination. None were competent at visual function and only four at ocular anatomy and binocular vision.

Conclusions:

a) Student learning experience: Lecturer background and training influenced student training as all the lecturers had trained in different countries. A clinical training protocol need to be implemented to optimise clinical competencies.

b) Existing healthcare context:Enhanced training needs should be addressed in clinics with more support staff and time to deal with complex patients.

c) Student capacity: Students that are more suitable for the course should be selected.

There are almost twelve million children (<18 >years) in Mozambique with minimal access to eye care. [1] Annual screening of school children by teachers for uncorrected refractive error is one of the most cost effective health interventions in Sub Saharan Africa.[2] The International Agency for the Prevention of Blindness (IAPB) has recommended that child eye health interventions be incorporated into National School Health Initiatives.[3]

In view of the IAPB position this presentation sets out to identify and discuss the main considerations in the design of a child eye health strategy, for the province of Nampula, Mozambique, which aligns itself with broader child health and education strategies.

The considerations discussed are relevant to organisations and institutions involved in the provision of primary child eye care through school screening.

Methods:

A review of published articles and white papers around current international trends in child eye health was performed. The Mozambique national, provincial and district educational and health systems were examined through the 2007 census and other published statistics. Interviews were conducted with representatives of the provincial health and education systems and an external bilateral aid representative. Local potential stakeholders in the child eye health programme were identified and interviewed; these included primary school principals, teachers and representatives from NGOs working locally and nationally.

Results:

Considerations will be discussed under the following headings: Social; Educational; Community; Health. A School Health policy exists in Mozambique but the implementation of the policy is not consistent in each province. The main considerations in Nampula are the lack of resources in education and health and the extreme poverty in which most children live. Potential areas for positive integration of child eye health were identified in several government run school and community health and education schemes.

Conclusion:

Highlighting potential barriers and opportunities to programme design ensures that it is sustainable and appropriate to the local setting. Familiarity and engagement with stakeholders in existing child health and educational systems in Nampula, as outlined in this presentation, will inform in the design of a child eye health programme and has the potential enlighten child eye health programme design in other countries.

References:

1. UNICEF - Mozambique - Statistics. 2012 16/11/2012]; Available from: http://www.unicef.org/infobycountry/mozambique_statistics.html.

2. Baltussen, R. and A. Smith, Cost effectiveness of strategies to combat vision and hearing loss in sub-Saharan Africa and South East Asia: mathematical modelling study. BMJ, 2012. 344: p. e615.

3. Gilbert, C., IAPB Briefing Paper: Integrating eye health into school health programmes, 2011, International Centre for Eye Health, London School of Hygiene and Tropical Medicine.