Secondary Eye Care Hospital in a Non-Government Organizational Hospital

Arif Hussain


Purpose: To investigate the clinical and cost effectiveness of the primary eye care (PEC) programmes at Munawwar Memorial Hospital (MMH) during one year study period of 2005-06. Methods: Four programmes of screening for visual anomalies, including cataract were evaluated in the rural district of Chakwal Punjab. Data was collected from hospitals records and referral slips were collected by the Refractionists / primary health care (PHC) workers. Refractionists led two of the programmes and the other two were led by PHC workers. Results: The findings showed that Refractionists were more cost effective in implementing the screening for cataracts in this study.  Furthermore, to increase the number of Refractionists solely for screening in out reach and in camps at primary level can become more costly blindness prevention activity. Conclusions: Although Refractionists may be more expensive to train initially, they can be more cost effective in implementing the screening for cataracts as shown in this study. However, this needs to be balanced when considering the lack of these trained personnel with the larger availability of PHC workers. A combination of Refractionists and PHC workers may be a suitable model for future work, where one Refractionist takes a lead role and co-ordinates many PHC workers. Both groups of workers can be used in other tasks to reduce costs to the screening programmes. Key words: primary eye care; primary health care, cataract surgery; clinical effectiveness, cost effectiveness.