VISION 2020 links programme

The VISION 2020 Links Programme originated as part of the ‘VISION 2020 - the right to sight’ initiative that was established in 1999 by the World Health Organisation and the International Agency for Prevention of Blindness to eliminate avoidable blindness worldwide.

• It works with overseas partner institutions (initially in Africa) to identify their main needs and priorities and then match those requirements with a suitable UK training eye unit.
• It is an initiative to give teaching eye institutions in developing countries the skills and resources to develop high quality programmes (including training) for eye care professionals (doctors, nurses and paramedical staff)

The International Centre for Eye Health (ICEH) promotes the development of links by acting as a resource and networking centre for existing Links and facilitates the development of new ophthalmic Links within NHS hospitals. A database of interested UK ophthalmologists has been set up to aid the matching process.

Picture: Dr T Lambart of Lusaka University Teaching Hospital, Zambia and Mr P Coles of Brighton and Sussex University Hospitals, UK shake hands after formalising their VISION 2020 Link, March 2007

How the links process works

The VISION 2020 Links Programme has a defined needs assessment process which helps to establish a foundation for sustainable partnerships between teaching institutions in developing countries and partner eye hospitals in the UK.

The VISION 2020 Links programme will endeavour to:

• help the overseas partners to identify their priority needs for eye care training
• match them with the most appropriate UK institution and facilitate the process
• look for ‘seed money’ for the needs assessment process
• organise orientation visits by key members of staff, UK to Africa and Africa to UK
• establish the Steering Committees for both partners
• facilitate joint discussion and agreement of the goals and objectives
• monitor and report to the V2020 Links steering committee on the Links as they develop

'The ultimate beneficiaries from UK professional health workers gaining international experience are NHS patients in the UK.' Professor Sir Liam Donaldson, CMO for England

Steps in the process

1. Ensure that there is a willingness in the eye department to develop a link
2. Needs Assessment process completed by overseas institution to identify priority needs for eye care training
3. Appropriate match within UK from institutions registered with VISION 2020 Links
4. Trust support for the link - management agreement needed - Steering Committee formed
5. Orientation visit from the UK to the overseas hospital
6. Return visit from overseas hospital to UK hospital
7. Joint discussion and agreement of goals and objectives. Memorandum of Understanding completed
8. Development of 3-5 year activity plan and financial plans
9. Monitoring and Evaluation plan in place
10. Funding – Trust arm – outside foundations, involvement of the staff. The two ‘link partners’ who choose to work together look for long-term funding

Benefits

For the overseas institution:

• Clinical skills transfer - diagnostic, treatment and administrative skills of all cadres of ophthalmologic staff will be improved through training in general or sub-specialty ophthalmology and through staff exchange
• Community focus - community eye health programs will be developed in order to increase poor peoples’ access to eye care and to increase awareness of eye health needs at all levels of the community
• Management of information - information technology capability will be built, facilitating the ability of the institution to access information, communicate electronically, and collect, store and analyse data
• Research - research capacity will be developed, giving local personnel the skills to formulate and answer questions important to blindness prevention in their local setting.

Links programmes benefit the UK institutions by offering staff development and job satisfaction through ‘hands on’ work in a developing country, improving teaching skills, morale (and hopefully staff retention), and increasing the status of the UK partner as an instrument for change in global eye care.

The Tropical Health and Education Trust (THET)

This type of ‘specialist’ eye link will be stronger if other departments are also involved and the link involves the whole organisation. One of the strengths of the VISION 2020 Links Programme is the close association with THET, a long standing general medical links programme that acts as an umbrella organisation to foster institutional links. Their website contains a mine of useful information including a ‘Links Manual’ - http://www.thet.org.  THET can have a greater influence, on behalf of both general links as well as specialist links, on funding through DfID and also with recognition of the ‘links concept’ within the Department of Health.

 ‘Links are about changing the health of people rather than only professional-to professional support. We need to constantly remind ourselves that the outcome of any link is to provide better services to more people.’ Professor Allen Foster-ICEH

Summary

The VISION 2020 Links Programme is willing and able to facilitate both partners through a ‘needs assessment’ partnership establishment process, which allows for a solid activities plan and budget to be drawn up between the two partners. We also encourage the development of a steering group in each of the partner institutions to assist in monitoring progress and redefining on a regular basis areas that need strengthening.

Links provide an innovative, sustainable and cost effective solution to health care delivery overseas by encouraging local health workers to develop their skills and thus enhance service delivery and staff confidence and morale. They allow for in-service training in which skills shared can be clinical, technical, community-based, organisational or managerial and are based specifically on identified local needs and priorities.

To date the International Centre for Eye Health has completed a preliminary needs assessment process with 13 centres/hospitals in Africa, one in Asia and two in Eastern Europe. Three of these are already linked with UK institutions, two others are in the process and the remainder are seeking partnerships with UK institutions to implement their identified priority needs.

Contacts

Marcia Zondervan, VISION 2020 Links Programme Manager, at marcia.zondervan@lshtm.ac.uk  or Nick Astbury, RCOphth Links Advisor, at nick.astbury@lshtm.ac.uk.