National Blindness Control Programme

Presented by :Sneha .Phalle Sneha . Gopalkrishnan

NBCP
It was launched in the year 1976 as a 100% centrally sponsored programme. India was the first country in the world to launch a national level blindness control programme. The implementation was decentralized in 1994-95 with the formation of district blindness society in each districts of the country.

GOALS
To reduce the prevalence of blindness (1.49% in 1986-89) to less than 0.3%. To establish an infrastructure and efficiency levels in the program to be able to cater new cases of blindness each year to prevent future backlog.

OBJECTIVES
To reduce the backlog of blindness through identification and treatment of blind. To develop comprehensive eye care facilities in every district. To develop human resources for eye care services. To improve quality of service delivery. To secure participation of civil society, NGOs, and private sector in eye care. To enhance community awareness on eye care.

National Program Management Cell State Program Cell

District Blindness Control Society

District

District Hospital Opthalmic Surgeon District Mobile Unit

District Health Officer

CHCs

PHCs
Medical Officers Paramedical Opthalmic Assistants

Organisation Structure
National Level: It is managed by Directorate General of Heath Service, Min. of Health and Family Welfare, New Delhi.
National Program
Management Cell Administrative Division (Addl. Secretary/ Joint secretary)

Technical Division (Deputy Director General)

State Level:
State Health Society is formed with the following members:
Chairman : State Mission Director/ Secretary Vice Chairman : Director Health Services Member Secretary : Joint/ Dy. Director (from the state cadre)

District Level:
The District Health Society has max. of 15 members, consisting of not more than 8 ex-officio and 7 other members as detailed below:

Chairman: District collector/ District Mission Director Vice- Chairman: Chief Medical & Health Officer Member Secretary: Officer of the level of Dy. CMO, preferably an
opthalmologist

Technical Advisor: Chief Opthalmic Surgeon of District Hospital. Members: Medical Suprintented/ Civil Surgeon of distict hosp.
District Education Officer Representatives from NGOs District Mass Media/ IEC Officers Prominent Practicing Eye Surgeons

Manpower & Infrastructure (2003)

states populatio No:of Eye Eye n distric facilities beds ts 900914 13782976 --------9 28 156 427 19 120 578 267 135 1601 4362 104 1663 4488 9673 Eye Opthalmic surgeons assistants 64 592 562 29 376 1128 740 -------------5 172 5 147 611 356 optom Totl etrists optic shops --------- 0 -----103 13 98 190 233 0 779 42 176 734 191

Chandig arh Delhi Gujarat Goa Kerala Mahara shtra Tamil Nadu

42735439 25 13343998 2 27953614 14 94565379 35 53870165 30

Eleventh Five Year Plan (2007-2012)

Following target has been set for the 11th five year plan: Prevention and control and management of Diabetes retinopathy Hospital based Screening of Glaucoma and prevention of childhood blindness. Improvement in the visual outcome of cataract surgery by performing IOL implantation. Development of Pediatric Ophthalmology Units. Development of fully functional eye bank networks. Developing human resource and institutional capacity.

STRATEGIES
The four pronged strategy of the program is: 1. Developing institutional capacity 2. Developing human resources for eye care 3. Strengthening service delivery 4. Promoting outreach activities and public awareness

REVISED STRATEGIES
Strengthening services for other causes of blindness. To shift from eye camp approach to a fixed facility surgical approach and from conventional surgery to IOL implantation. To expand World Bank projects to the whole country. To strengthen participation of voluntary organisations to enhance the coverage of eye care services to tribal and other under served areas.

Cataract Operations Involvement of NGOs Civil works Training Commodity Assistant Information, Education, Communication Management Information System Monitoring and Evaluation School eye screening program Collection and utilisation of donated eyes

ACTIVITIES

OTHER MAJOR ACTIVITIES

Control of vitamin A deficiency Control of Trachoma Ophthalmic assistant

FUNDING
Funds will be released by the GOI to State Health Society based on annual action plan. For release of funds, the state society has to submit the following documents: Statement on performance and expenditure Audited statement of accounts Utilization certificate State annual action plan for the current year GOI will release funds into 2 equal installments, first will equivalent to 50% of planned budget and second will be released on basis of progress made. The central government has allocated Rs.1550 crore under the 11th plan for national program which was just Rs.450 crore in 10th plan.

 Though it is a Central Govt program, major service providers are NGOs, non- profit orgs, private, corporate hospitals, philanthropists, volunteers. Since almost 75-80% of eye care within the country is provided through non govt. organisations, this resource should be used appropriately.

Funds Released & Expenditure for the Year 2010-11

Particulars Amount (lakhs)

Income
Unspent balance of previous year (08-09) in hand 158.27
Amount received under GIA Amount received (For 5 Medical Colleges) Interest 1000.00 200 11.67

Total Funds available (1+2+3)

Release & Expenditure Total Release & Expenditure incurred Total Balance available

1169.94

707.39 462.55

Latest Data For NBCP

Year 2002-03 2003-04 2004-05 2005-06 2006-07 2007-08 2008-09 2009-10 2010-11 Target Achievement Percentage IOL Percentage 70.00 % 93.35 % 240000 224049 83.00 % 97.45 % 240000 233870 89.26 % 104.49 % 250000 261224 94.50 % 109.85 % 250000 274619 116.39 % 97.00 % 250000 290973 92.00% 98.00 % 350000 187545 84.00 % 98.00 % 450000 376143 91.02 % 98.47 % 450000 409601 95.49 % 98.72 % 450000 429695

KERALA
Cataract is the main cause of blindness in Kerala state. There are about 2.5 3.0 lakhs blind people in Kerala. There are about 25-30,000 corneal blindness cases.

Vitamin A Prophylaxis Programme

It is a part of National Program for Control of Blindness (India) It was launched by the Ministry of Health and Family Welfare in 1970 It utilises technology developed by National Institute of Nutrition, Hyderabad It has helped to decrease the preventable blindness in the community

 Children between nine months to three years are given six monthly doses of vitamin A. The administration of the first two doses is linked with routine immunisation.

Objectives:
To decrease the prevalence of vitamin A deficiency from current 0.6% to less than 0.5%

Strategy:
Health and nutrition education to encourage colostrum feeding, exclusive breast feeding for first 6 months. Adequate intake of Vit A rich foods thereafter. Early detection and proper treatment of infections. Prophylactic Vit A as per following dosage schedule: 100000 IU at 9 mnths with measles immunisation 200000 IU at 16-18 mnths, with DPT booster 200000 IU every mnth upto 5 yrs Thus, a total of 9 mega doses to be given from 9 months upto 5 yrs.

Sick Children
All children with xerophthalmia are to be treated

at health facilities. All children having measles to be given 1 dose of Vit A if they have not received it in the previous month. All cases of severe malnutrition to be given one additional dose of Vit A.

VISION 2020
Right to sight. To eliminate the main causes of

avoidable blindness in India.

Challenges in implementation

*identified by department

5 challenges perceived by VISION 2020 INDIA

1) 2) 3) 4) 5) NGO/ Voluntary sector participation Strengthened Public Sector Convergence Rehabilitation services Human resources

Thank you!!!