Mid-level cadre providing eye care in the context of Vision 2020

The contribution of the mid-level cadre of eye care providers is an essential component of the Vision 2020: The Right To Sight initiative, to eliminate avoidable blindness by 2020. However, for the past 20 years the functions of this cadre have not been definitively outlined, or universally accepted. Consequently, the competencies they require to provide high quality comprehensive eye care have not been established. This has had implications for both training programmes and the subsequent deployment of the graduates of these programmes. This paper examines, mainly through a review of World Health Organization (WHO) documentation, the progress that has been made in defining the role and outlining appropriately enabling training of this cadre of mid-level personnel. As a result of this analysis, recommendations are made concerning the development of this cadre to provide eye care in the context of Vision 2020: *Develop consistent and widely applicable nomenclature *Outline workplace functions and job descriptions, so that personnel can be categorised by their competencies and functions. *Develop curricula based on the competency requirements of job descriptions and that will prepare personnel for those jobs. *Establish and/or develop training centres, including those capable of training trainers. *Establish government recognition, resources, support, and evaluation and feedback systems to ensure that this mid-level cadre can implement their training, and have the opportunity of providing high quality eye care.