Johns Hopkins University

Let There Be Sight: Solving the eyeglass problem in Africa Highly Ranked

Lead Organization

Johns Hopkins University

Baltimore, Maryland, United States

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To learn more about – or provide significant funding to – this project, please contact Lever for Change.

Project Summary

There are currently 2.5 billion people worldwide who cannot reach their full potential because they need eyeglasses but don’t have them. Starting in four countries, we will ensure that everyone has access to high-quality, affordable vision care. Our solution is transformative. It is part infrastructure: a vast network of Vision Centers and community health workers, part innovation: the USee™, and part social change: local investment in and demand for eyecare. We will establish self-sufficient Vision Centers in District Hospitals and extend their reach and impact by empowering community health workers to become “Visionpreneurs”. Visionpreneurs will use the USee™ to deliver prescription eyeglasses to the most vulnerable people on-the-spot anywhere after just one day of training. A robust public health campaign will expand knowledge of vision care, build demand for services, and foster public and private investment in the eyecare system. The result: a fully sustainable, locally-owned system for protecting sight.

Problem Statement

Over 2.5 billion people worldwide need eyeglasses but don’t have them. Throughout Africa, 20-35% of people have vision impairments, but 80% can be corrected with properly diagnosed eyeglasses. Uncorrected vision limits productivity in school and the workplace and contributes to workplace accidents and road traffic injuries, which are the leading cause of death for young people worldwide. Marginalized groups are the most affected, including poor, rural, and minority populations. Poor vision contributes to cycles of inequality, poverty, and poor health. Challenges to comprehensive eyecare include:Diagnosis: There are not enough trained eyecare professionals to provide eyecare to everyone. There is approximately one optometrist per 1,000,000 people in Africa.Distribution: There are not enough vision centers, vision screening tools, and affordable prescription eyeglasses. Many have to travel long distances to access these services.Demand: Low awareness and knowledge of eyecare and prevent use of vision services when available. In some communities, wearing eyeglasses is unpopular or stigmatized.Dollars: Eyecare is often too expensive. Governments, workplaces, and private sector have underinvested and under-prioritized eyecare as an essential component of healthcare.Sustainable change requires a multifaceted approach that addresses all of these barriers by empowering lay persons to provide eyeglasses, increasing physical access to services, building awareness and demand for those services, and fostering local investment. In particular, employing new tools that allow anyone- not just trained optometrists- to prescribe accurate, affordable eyeglasses is a game-changer. When complemented with interventions to increase permanent access, demand, and local investment, the results are revolutionary.

Solution Overview

Our three-tiered solution combines multiple tested models of strengthening vision and healthcare systems. 1.Distribution and Diagnosis. We partner with local governments to establish Vision Centers, often within District Hospitals, to increase access to affordable, high-quality eyecare. After initial investment and capacity building, Vision Centers become fully independent and self-sustaining in three years, leaving the community with permanent access to eyecare. We will further expand reach and impact by empowering community health workers as Visionpreneurs. Visionpreneurs will be linked to a Vision Center, represent the first touchpoint for many families, use the Usee™ Vision Kit to diagnose and provide inexpensive prescription lenses on-the-spot, and refer patients to the Vision Center.2.Demand. We will use evidence-based approaches to increase awareness of the available services and positively influence emotions, beliefs, and attitudes about eyecare.3.Dollars. With public sector institutions, civil society, and employers, we will advocate for investment in eyecare as a health and development priority.Numbers of functional Vision Centers, active Visionpreneurs, vision tests conducted, and eyeglasses dispensed; knowledge of and positive attitudes toward eyecare; and local investment in vision care will indicate progress.In five years with this grant, we will ensure everyone in Tanzania, Madagascar, Ghana, and Mozambique who needs eyeglasses can access and afford them through Vision Centers, Visionpreneurs, or in the workplace. Demand and local investment activities will create lasting change in communities and markets, so that individuals will continue to seek vision care, and local market institutions will respond to community needs.

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