A new and improved way to REACH school aged children of India

October 2021

Orbis's school screening program has new strategies and initiatives that make it an apt program to reach out to children enrolled in schools and otherwise. It also covers the scope of providing continuum of care to the community through the setup of vision centers

Orbis, in association with its partners, has come up with a new and improved way to reach out to school aged children in India. With the impact of COVID-19 and subsequent lockdowns. building on the learnings from the past year, Orbis decided to bring the children of India an eye screening model that will go above and beyond the regular form of screening strategies.

Refractive Error Among Children-Phase II (REACH Phase II) has been brought forth with the generous support of Rusy And Purviz Shroff Charitable Foundation and Jackson Kemper Foundation in Kerala, Madhya Pradesh, Maharashtra, and West Bengal.

While the program has taken off in four locations, the remaining are scheduled to begin in 2022.

Reach Phase Ii-What's New?

door-to-door screening

for maximum reach

even in the face of adversities such as the current pandemic

Vision centers

to shift accountability for child's eye care

from hospital teams to the community

compliance checks

by teachers through a standardized format

to increase spectacle compliance among children

comprehensive coverage

allowing for reaching out to out-of-school

and vulnerable group of "school-aged children"

End-to-end data management

through REACHSoft

and D2D screening app

Sustainable, cost effective and replicable

school eye health model

for future expansion

Looking Back at Children's Eye Screening

When Orbis began its children's eye care in India under India Childhood Blindness Initiative

Small children in a rural Indian village stand by an eye test stuck onto a post as part of the India Childhood Blindness Initiative (IBCI)

In the process, the focused approach was lacking. Through the traditional method, Orbis partner hospital teams depended on teachers for receiving initial report on children with eye problems. It was after they received the report, they conducted screening confirmatory camps where children referred for further eye exam would be identified for treatment, surgeries or any other interventions. Through this process, it was difficult to track information about every child as most of the record keeping was paper based. Apart from that, it was the base hospital team that took on the daunting task of working with all schools in the catchment which was often outside the reach of the hospitals. The vast distance acted as a deterrent for children who were further referred from the community camps to the base hospital for treatment.

Among many other factors, a notable one was the unavailability of choice for children prescribed with spectacles. Over the past years studies have found that children's compliance to spectacles has a correlation with their ability to choose their spectacles.

Keeping the above aspects in mind, Orbis worked with its partners to bring the children of India the REACH Program. Now known as REACH Phase I, the program focused on sending dedicated and skilled teams to schools to conduct screenings. Through the program a whopping 4.5 million children were reached. Teachers' role had changed from primary screening to eye health promotion among students and were oriented on the same. Children had the wonderful ability to choose their spectacle frames.

Even though we brought forth an evolved model, there were certain aspects that needed to be re-strategized. For instance, the burden of undertaking the task of school screening lay majorly on the tertiary facilities. Apart from that, despite change in several strategies, children's compliance to spectacle wear had not exponentially improved. It was an area that needed further focus and improvement. REACH Phase II hopes to approach these issues through a new lens. For instance, school going children's spectacle compliance would be the responsibility of teachers as a first. In terms of referral compliance, it would be the responsibility of their parents to take them to the nearest vision center and, if necessary, to the partner hospital for further intervention.

Transitioning to Screening of School Children Through Reach

By ushering in focused child screening programs such as Refractive Error Among Children (REACH), Orbis took the bold step of conducting a large scale pilot which enabled partner hospitals spread across India. REACH-Phase I brought with it a lot of benefits and learnings.

By building on those learnings, Orbis, along with its partners, hopes to close the gaps that could not be addressed earlier.

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