Tribal Odisha Eye Disease Study # 11 - Particularly vulnerable tribal group eye health program. Program protocol and...

Area of Science:

• Ophthalmology and Public Health
• Tribal Health Initiatives
• Vision Care Delivery Models

Background:

• Particularly Vulnerable Tribal Groups (PVTGs) like the Dongria community face significant barriers to accessing healthcare, including eye care.
• Limited access to vision screening, refractive error correction, and treatment for eye diseases contributes to preventable visual impairment in tribal populations.
• A structured eye health program is essential for addressing the specific needs of remote and underserved communities.

Purpose of the Study:

• To describe and validate a novel eye health program protocol tailored for the Dongria tribal community in Rayagada district, Odisha, India.
• To assess the feasibility and effectiveness of a multi-tiered vision care delivery system involving community health workers and vision technicians.
• To establish a framework for planning and resource allocation for eye care services for Particularly Vulnerable Tribal Groups (PVTGs).

Main Methods:

• A three-segment program involving home-based vision screening by community health workers (CHWs), followed by refraction and spectacle prescription by vision technicians (VTs).
• Referral to a vision center (VC) for slit-lamp examination and further assessment, with onward referral to a secondary center (SC) for comprehensive examination and treatment.
• A pilot study involving 126 individuals was conducted to rehearse the protocol, with inter-observer agreement assessed between optometrists and VTs/CHWs.

Main Results:

• The pilot study included individuals with a mean age of 44 years; 70% were illiterate, and 97.6% had never worn spectacles.
• Prevalence of eye conditions included 41% with cataract and 12% with pterygium.
• Good agreement (k = ~0.8-1.0) was observed between optometrists and VTs/CHWs for most eye conditions, indicating high reliability of the trained personnel.

Conclusions:

• The pilot study successfully confirmed the program modality, demonstrating its potential for effective implementation in the Dongria tribal community.
• The validated protocol provides a robust model for delivering eye care services to remote and vulnerable populations.
• Successful execution of this program will aid in future planning and resource allocation for eye care initiatives targeting Odisha's PVTG population.