Beyond Coverage: A Pragmatic Path to Effective Eye-Care Coverage in Low-Resource Settings

Area of Science:

• Public Health
• Ophthalmology
• Global Health

Background:

• The global eye-health agenda prioritizes effective vision restoration over service volume.
• Resource-limited settings face significant challenges in delivering comprehensive eye care.

Purpose of the Study:

• To propose a pragmatic eye-care playbook for resource-limited settings.
• To align with World Health Assembly Resolution 73.4 and WHO 2030 targets for effective coverage.

Main Methods:

• Implementing complete screening-to-spectacles pathways for children, including on-site refraction and timely delivery.
• Expanding cataract surgery access by tracking key indicators like effective cataract surgical coverage (eCSC).
• Addressing workforce shortages through competency-based task-sharing and asynchronous tele-ophthalmology.

Main Results:

• The proposed approach is human-centered, feasible at district scale, and aims for rapid, equitable vision gains.
• Somalia-specific data highlights unmet needs in refractive errors and blindness.
• Outreach eye camps demonstrate real-world delivery capabilities.

Conclusions:

• The playbook offers a feasible model for improving eye health outcomes in underserved populations.
• Effective coverage targets (eCSC/eREC) guide the strategy for sustainable eye care.
• Integrated, pragmatic approaches are essential for achieving global vision goals.