National Programme for Control of Blindness

NATIONAL PROGRAMME FOR CONTROL OF BLINDNESS

Introduction

National Programme for Control of Blindness (NPCB) was launched in the year 1976 as a 100% centrally sponsored programme with the goal of achieving a prevalence rate of 0.3% of population by 2020. Rapid survey on avoidable Blindness conducted under NPCB during year 2006-07 showed reduction in the Prevalence rate of Blindness from 1.1% (2001-02) to 1% (2006-07). With a view to achieve the above said objective, the Government has decided to continue this scheme during the 12th Plan with increased assistance for various component under the Scheme.

The four pronged strategy of the programme is:

Strengthening service delivery,

Developing human resources for eye care,

Promoting outreach activities and public awareness and

Developing institutional capacity.

From the financial Year 2013-14 it was decided to continue the NPCB under the NCD flexi pool within the overarching under the recently approved National Health Mission.

The main objectives of the Programme are:

To reduce the backlog of blindness by identifying and providing services to the affected population. To expand coverage of eye care services to the underserved areas;

To provide high quality of eye care services to the affected population;

To develop institutional capacity for eye care services by providing support for equipment and material and training personnel.

These Objectives are routinely implemented by adopting the following strategies-

Decentralized implementation of the scheme through DHS;

Reduction in the backlog of blind persons by active screening of population above 50 years, organizing screening eye camps and transporting operable cases to eye care facilities;

Involvement of voluntary organization in various eye care activities;

Participation of community and Panchayat Raj Institutions in organizing services in rural areas.

Development of eye care services and improvement in quality of eye care by training of personnel, supply of high tech equipments, strengthening follow up services and monitoring of services;

Screening of school going children for identification and treatment of Refractive Errors; with special attention in underserved areas.

Public awareness about prevention and timely treatment of eye ailments.

Special focus on illiterate women in rural areas. For this purpose, there should be convergence with various ongoing schemes to cover of women and children.

To make eye care comprehensive. Besides cataract surgery other Intra Ocular surgical operations for treatment of Glaucoma, Diabetic Retinopathy etc. may also be provided free of

cost to the poor patients through government as well as qualified non government organizations.

FUNCTIONAL STRUCTURE OF NATIONAL PROGRAMME FOR CONTROL OF BLINDNESS, SIKKIM.

1. Review of physical and financial targets achieved in this financial year 2015-16

1. CATARACT OPERATION WITH I.O.L IMPLANTATION

TARGET – 800


STNM Hospital

256

DHS EAST

77

DHS WEST

0

DHS NORTH

0

DHS SOUTH

97

NGO

7

Pvt. Sector SMIMS(Tadong)

23

TOTAL

460

During the year 2015-16, total of 460 cataract cases were operated with IOL implantation.

Above diagram showing the percentage of Cataract Patients operated district wise in the Free Cataract Operation Camp organized in the year 2015-16

Treatment/ Referral of other Eye Diseases.

Diabetic Retinopathy
(Laser Techniques)
132
Glaucoma
203
Corneal Opacity
(Peripheral)
160
Squint
137
Intraocular Trauma
249
Total:
882

Diagram shows the number of Other Eye Disease patients offered treatment or referred during the year 2015-16.

2. Target and achievement

Target : 800
Achievement
Percentage
Total
460
57.5
IOL implantation – 90%
450
100
Women beneficiaries – 55%
184
41
Surgery on bilaterally blind
50%
17
1.5
SC/ST/BPL – 50%
136
30
Referred cases
102 cases (referred
to higher centres)

Cataract Achievement 2015-16:-

During the year, total of 460 Cataract cases were successfully operated, which is 57.5% of the total target for the year, out of which 41% were women beneficiaries, 1.5% were bilateral cases and 30% were ST/SC/BPL patients. However, total of 102 patients were referred to higher centres (viz. SGLEH, AIIMS New Delhi, Apollo Kolkata, etc.) for further treatment.

Reason for Shortfall:-

Desired number of Cataract Camp could not be hold due to busy schedule of District officials.

PHC’s M.Os are unable to pay desired attention in NPCB due to pre-occupation in other programmes and day to day work.

Camps held in monsoon season faces communication setback due to road blockage which is a habituated problem in our State.

Lack of Ophthalmic manpower especially in the Districts

Future Strategies:-

Training of ASHAs and PRI for surveillance of person with Eye diseases.

Strengthening of transportation system of patients and registration of patients.

Mass survey has to be done on Cataract backlog and cataract beneficiaries.

B. SCHOOL EYE SCREENING (SES)

TARGET :3500ACHIEVEMENT
TOTAL CHILDREN
SCREENED
15758
CHILDREN TO BE DETECTED
WITH REFRACTIVE ERROR
711
FREE SPECTACLENIL
EYE DONATIONNIL

Under School Eye Screening, PMOAs of all the District Hospital and STNM Hospital visit schools in their respective area and screen the children for refractive error and other diseases and correct them. Distribution of free spectacles could not be done as the rate quoted were higher than stipulated norms.

C. Training

EYE SURGEONS
NA
ASHA
24
AWW
94
MPHW
45
GNM & ANM
50

During the year 2015-16, a Total of 24 ASHAs, 94 AWWs, 45 MPHW and 50 GNM/ANM were trained at State, District Hospitals, by NPCB officials and Ophthalmologists. Training programme are being organized as per the approval from GOI, where participants from various fields are called upon to refresh and update their knowledge timely. 8 Teachers were trained by PMOAs, during School Eye Screening (SES) Camps.

D. I.E.C. CAMPAIGN/ ACTIVITIES

State wide publicity was is done though different means of media during various eye related important days like, World Sight Day, World Glaucoma Day, National Eye Donation Fortnight Week event, e.tc.. Talk on prevention, control and treatment of eye diseases was given by HOD Ophthalmology-cum- Consultant NPCB, on Nayuma T.V. Extensive publicity in respective districts and PHCs through local cable, All India Radio, distribution of leaflets, installation of banners and PA system also were used. Posters & Hoardings has been displayed in Hospital and public places. Regular Sanitation, Awareness, education and Information programme on eye diseases and its control and prevention is being done throughout the year.

EQUIPMENTS

Ophthalmic equipment like AB Scan, B scan, Operating Microscope, Slit lamp, Applanation Tonometer, Streak Retinoscope, Direct Ophthalmoscope e.t.c. for State and district Hospitals was procured through State government approved rates and handed over to respective District Hospitals Incharge for smooth functioning of Eye OPDs and O.T.

GOI funds for purchase of Mobile Ophthalmic Unit to NPCB, SHS during 2014-15 is completed and handed over to District Hospitals.

F. MANPOWER RECRUITMENT:

Manpower has been a driving force behind success of NPCB Programme in the State. It is an integral part of the programme for proving public services and there by achieving the main goals of NPCB. During the current year, no new recruitments were done in filling up the post under National Programme for Control of Blindness as per the direction of State Health Department. Appointment of Ophthalmologist at two District Hospitals is targeted in years to come. Below is the status of Manpower position under NPCB, Sikkim :-

MANPOWER

(Skilled & Administrative)

LOCATIONIN POSITION 
REGULARCONTRACTUAL
SHS/S.T.N.M Hospital,
State
Consultant Eye Surgeon
1
Nil
SPO
1
Ophthalmologist
1
PMOA
3
5
Nurses
Nil
Nil
BFO
1
U.D.C
NIL
Administrative Assistant
1
Data Entry Operator
1
Peon
1
Multi tasking staff
1
Driver
b) DHS/District Hospitals.
b.1.) EAST:
Ophthalmologist
Nil
1(NRHM Appointed)
PMOA
7
b.2.) WEST:
Ophthalmologist
Nil
nil
PMOA
3
b.3.) NORTH:
Ophthalmologist
Nil
Nil
PMOA
1
4
b.4.) SOUTH:
Ophthalmologist
Nil
1(NRHM Appointed)
PMOA
1
6

2. Financial Statement of receipt & Expenditure

Expenditure and Present Balance under NPCB/SHS accounts
Sikkim as on 31.03.2016 (` rupees in lacs)
    
DepartmentO.B GIA EXP.Cl.BAL.
NPCB/ SHS102.9156.00111.6847.23
Expenditure/Fund Allocation head during previous year 2015-16
ACTIVITYExpenditure(
in lacs)
Cataract Camp
7.28
IEC
4.89
School Eye Screening
0.32
Management of State Health Society, contingencies, T.A/D.A,
Salaries, e.t.c.
10.75
Other Eye Diseases
6.39
GIA for strengthening district hospital
40.00
GIA for sub divisional Hospital
6.46
Training
1.86
Maintenance of Ophthalmic Equipments
.51
Salary of Ophthalmic Assistant
33.22
Total111.68

Brief Summary:

During the financial year 2015-16, GOI sanctioned a sum of `198.21 lakhs,

however the sum of ` 56.00 lakhs was released and received during the year

by NPCB Sikkim. Out of which the expenditure incurred during the year from the total GIA received is 111.68 and 47.23 lakhs was remain as unspent balance at the end of financial year.

Identifying areas of Bottleneck (Infrastructure/equipment) in programme implementation measures to overcome them.

Infrastructure:

NPCB has constructed one Dedicated Eye O.T/Ward in Singtam & Namchi District Hospital respectively from the sanctioned budget allotted to the cell. Two more dedicated Eye wing is to be constructing in the West District, and District Hospital North is targeted in coming years. Only six bedded eye ward is there in the State Hospital which is not enough for the operation and camp days.

Equipments:

Procurement of equipments like A.B Scan, Operating Microscope, Trial sets, Vision Testing and other basic equipments and instruments for eye testing was done during the year. Budget of Grant in Aid for Strengthening of District Hospital, Sub-Divisional and Vision Centre was utilized for procurement of Equipments. Instruments purchased were successfully installed in District Hospital for providing services to the needy peoples. More such equipments are to be purchase for state hospitals and District hospitals to replace the nonfunctioning, irreparable and obsolete ones.

STRATEGIES FOR 2016-17

Total of 1200 Cataract Patients are targeted to operate during the year 2016-17.

3500 numbers of Students are to be provided free spectacles at the stipulated rates.

Procurement of Eye Equipments and installation at District Hospitals , and State Hospital for smooth functioning of the programme.

Construction of Dedicated Eye Wing at District Hospital, Mangan, North and Gyalshing, West, Sikkim.

Appointment of Ophthalmologist at District Hospitals and PHCs.

Proposed for appointment of Driver for two Mobile Ophthalmic Unit purchased during 2013-14 and 2014-15.

Distribution of free spectacles to school going children prescribed for wearing glasses.