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Dear Readers,
Eye care set in the service sector is a human intensive field. For proper delivery of service whether in the community or in the hospital human resource is a must. This particular issue focuses on the theme �Human Resource in Eye Care�. This issue begins by providing an overview of the different types of personnel required in eye care. It then looks at how eye care is provided at the primary, secondary and tertiary level and the human resource requirement in each centre. The job description for various cadres of staff in the hospital is provided. To estimate the human resource required there are various calculations which have been based on the need in the community, magnitude of blindness, proportion of staff required for a million populations. For the staff in the hospital what are the human resource development opportunities which can be provided to them. Training is discussed here. Today to train an eye care worker there are not enough training institutes. An attempt is made to put together all the different training institutes for eye care mainly related to mid level ophthalmic personnel. Even when a organization gets a trained person retention is a key challenge. The case studies highlight from different areas what are the retention issues in different parts of the world. The issues faced in different parts of the world are different. This is pieced together to understand the challenges and Retention for human resource in eye care in different parts of the world. To manage people better one needs to apply the HR practices which do not vary much across sectors. Links to HR resources are also provided to facilitate this.
Wish you a productive reading!

Happy reading!
Regards,
Vision 2020 e-resource team
The Issue Features...
Human Resources in Eye Care
Vol. 2 No. 11 November 2005
• Human Resources in Eye Care
• Types of Human Resources Required in Eye Care
  1. Medical
  2. Paramedical
  3. Administrative

• Eye care Personnel For Different Eye Care Model
  1. Vision Centre
  2. Secondary Eye Care
  3. Tertiary Centers

• Job Description
• Tools and Technique For Manpower Planning
• Human Resource Development
• Training
• Constraints in HR in Eye Care and Alternative Suggestions
• Collaborating Partner



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Vision 2020 – The Right to sight is recommending a two to five fold increase in the volume of cataract surgery. The only way to accomplish this feat is to make best use of available personnel and facilities and to become organized to reach more people in need. These efforts will require considerable strengthening of programmes, expansion of trained staff, and engagement with communities in ways that stimulate people in need of surgery to come forward early in their progression toward blindness. In so doing, the likelihood of a programme being capable of sustaining itself from modest patient fees is enhanced.

-WHO, 1999.

  1. COMPREHENSIVE PLANNING OF HUMAN RESOURCES FOR EYE CARE TO MEET THE GOALS OF VISION 2020: THE RIGHT TO SIGHT

  2. Abstract:
    This study is based on the criteria to review the status of the eye health workers with regard to number, mix, distribution, the areas of of deficiency and major areas for reform in educational policies and to come out with a policy on the Human Resources development for Vision 2020 - The Right to Sight programme.


  3. HUMAN RESOURCE DEVELOPMENT FOR VISION 2020
    Abstract:
    This article is a modified version of a presentation at the workshop on Human Resource Development for VISION 2020 in Africa, which took place at the PAACO meeting in Tunis on 21 May 2003.


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Some of my friends have asked me how we have trained our staff in “the Aravind culture.” An industrialist from Delhi once came and said, “I need to build a hospital, and I am very much impressed with your hospital. Could you come and start a hospital in Delhi for me? I asked, “What is it you want? You have all the money you need. It is not difficult for you to put up a hospital in Delhi. Why don’t you do it?” He said, “No, I want a Hospital with the Aravind culture. People are cordial here. They seem to respect people more than money. There is a certain amount of inner communion or compassion that seems to flow from them. How do you do it?”

- Dr. G. Venkataswamy

Human Resources, both clinical and non-clinical staff, play an important role in the effective functioning of an eye care institution. Based on the nature of job they perform they are divided in to three categories Medical, Paramedical and Administrative staffs.
  • Medical
    The Medical people are Ophthalmologist who examines diagnoses and treats diseases and injuries of the eye - evaluating medical and surgical histories, assessing visual and examining the eye. Ophthalmologists perform local anesthesia and surgical procedures, including laser surgery, then prescribe various ocular and systemic medications.
  • Paramedical
    Para medicals are the Optometrist / refractionist - those who do the initial evaluations, Visual Acuity, refraction etc , Ophthalmic nurses / Assistants - assist the doctors and involves in all type of clinical supportive services of Out patient Department, Ward and Theatre, Lab Technicians - Do all Microbiological and Biochemistry tests. E.g. Blood group investigation, urine sugar test, serology test etc. Medical Record Technician - Takes care of registration and management of medical records. Counselors - Help the patients to understand regarding eye diseases and guide them in decision making.

    Use paramedical staff in the correct ophthalmologist-to-paramedical ratio (usually one ophthalmologist to five paramedicals) in order to free up ophthalmologist time to perform surgery and to lower costs by utilizing less expensive professionals.

    David Green, Seva Consultant

  • Administrative
    For the clinical team to be productive, some one has to ensure that the patient load is adequately maintained, sufficient supplies are available, and equipment is in good working condition. Finances must be available, adequate manpower, clean surroundings and there must be adequate controls to ensure accountability. Health education and preventive measures must be promoted to reduce the morbidity levels in the community. Hence, there are many activities that need to be performed to complement the performance of the eye surgeons and clinical team in order to ensure that the eye care services are provided both effectively and efficiently this part is taken care of Administrative and supportive services.
  1. TYPES OF HUMAN RESOURCES REQUIRED IN EYE CARE
    Abstract:
    This article is on overview of the different types of personnel required in eye care and the functions performed by them.

  2. THE EYE CARE TEAM

  3. THOUGHTS ON ESTABLISHING MID-LEVEL OPHTHALMIC PERSONNEL FOR VISION 2020 IN INDIA


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Vision Centre:

Vision centers are started with the main objective to create permanent access to the rural communities to increase the uptake for eye care services. This centre offers primary eye care services with the help of trained ophthalmic technician at an affordable cost. The centre is connected with the base hospital through internet services to enable direct patient consultation and interaction with the ophthalmologist. In order to make health behavioral changes in the community it advocates awareness programs to promote better eye health practices. Community ownership is important to sustain the activities of the centre and hence village volunteers are identified and trained to create link between the community and the centre. For the effective reach of the community concrete efforts have been taken to network with Government, NGO’s and other prominent leaders in the area.
  1. LVPEI VISION CENTER
    Abstract:
    This article contains the background, Need and Infrastructure required for starting a Vision center.
Secondary Eye care:

Secondary eye care services refers to providing a mix of preventive, curative and rehabilitative eye care interventions with a greater focus on curative services within the basket so as to bring about a significant reduction in blindness and ocular morbidity in its service area. Since most of the blindness can be prevented or treated with secondary level interventions, it is important that this level remains most cost effective.
  1. LVPEI SECONDARY LEVEL EYE CENTRE
    Abstract:
    This article discusses about the Design, Infrastructure, Equipment, Human Resources, Service delivery and Financial self sustainability of Lvpei Secondary Level Eye Centre.

  2. HUMAN RESOURCES DEVELOPMENT
    Abstract:
    This article focuses on the need for Human resources in Eye care also it has a model Human Resource Structure for a Centre Serving 500,000 in India.

Tertiary Centers:

  1. HUMAN RESOURCES IN EYE CARE
    Abstract:
    This article contains some of the staffing pattern of Secondary and tertairy eye care centers like Kilimanjaro Centre for Community Ophthalmology, Aravind Eye Hospital Madurai, and Seconday Hospital Theni.

  2. BANGLADESH MODEL OF EYE CARE
    Abstract:
    This article provides details on the model of Modular Eye Care (MEC) developed in several districts of Bangladesh between 1994 and the end of 1999.


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The Quality of clinical outcome is largely dependent on the skills of the ophthalmologists and the paramedical staff; this can be achieved by specifying the nature of Job clearly.

Job Description is a written document which tells the job holder what he/she has to do, how the work should be done and also the purpose of work. Job Description should clearly define the job responsibilities, duties and tasks to be done and should have Job Identification, Job Summary, Duties to be performed, Relation to other jobs/departments, Supervision to be given/taken, Type of tools/equipments used, Condition of Work etc. Some of the reasons to have Job Description are
  • Role clarity for the job holder
  • Keeps the employees focus on the job.
  • Training Need Assessment could be done by referring the Job Description
  • Evaluation of the employees performance could be easily done.
  • Increase in pay and bonus could be given with reference to Job Description.
  1. JOB DESCRIPTION FOR GENERAL OPHTHALMOLOGISTS
    Abstract:
    This is a model job description for the Medical Officers in an Eye Hospital. It clearly focuses the duties of the Medical Officers, and how to manage the duties in an organized way.

  2. JOB DESCRIPTION FOR UNIT HEAD
    Abstract:
    This is a model job description for the Unit head in an Eye Hospital. It clearly focuses the duties of the unit head, and how to manage the duties in an organized way.

  3. JOB DESCRIPTION FOR THEATRE PARAMEDICS
    Abstract:
    This is a model job description for the Operation theatre nurses in an Eye Hospital. It clearly focuses the duties of the paramedics, and how to manage the duties in an organized way.

  4. JOB DESCRIPTION FOR WARD PARAMEDICS
    Abstract:
    This is a model job description for the Ward nurses in an Eye Hospital. It clearly focuses the duties of the paramedics, and how to manage the duties in an organized way.

  5. HOUSEKEEPING JOB DESCRIPTION
    Abstract:
    This is a model job description for the House keepers in an Eye Hospital. It clearly focuses the duties of the House keeping staffs, and how to manage the duties in an organized way.

  6. JOB DESCRIPTION FOR COUNSELLORS
    Abstract:
    This is a model job description for the Counsellors in an Eye Hospital. It clearly focuses the duties of the Counsellors, and how to manage the duties in an organized way.

  7. JOB DESCRIPTION FOR CAMP ORGANISORS
    Abstract:
    This is a model job description for the Camp Organisors. It clearly focuses the duties of the Camp Organisor, and how to manage the duties in an organized way.


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Calculations on the number of human resource required are based on certain premise like number of ophthalmologists required per million populations. Vision 2020 has also come up with their recommendation of what could be staffing in each department.
  1. VISION 2020 DATA UPDATE
    Abstract:
    This tools consists of CSR, no of Ophthalogist, Refractionist, Oppometrist, Surgeries etc of Different countries in the world.


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Quality in eye care is a team effort. This is achieved when all staff members have the basic training to develop the necessary technical skills. Task-to-skill matching and continuing medical education ensure that staff use their skills effectively and continue to develop their skills. So we have provided you with some useful websites which will be useful for the staff development.
  1. HEALTHCARE AND HR RESOURCE
  2. HUMAN RESOURCES
  3. HR TO THE RESCUE
  4. THE HR ANSWER BOOK
  5. THE HR SCORECARD
  6. HR INTERNET GUIDE
  7. MERCER HUMAN RESOURCE CONSULTING
  8. SOCIETY FOR HUMAN RESOURCE MANAGEMENT
  9. IHRIM (The International Association for Human Resource Information )
  10. HUMAN RESOURCES ONLINE
  11. US INTERNETWORKING (USi)
  12. HR INTERNET GUIDE DIRECTORY OF SITES FOR HUMAN RESOURCES PROFESSIONALS AND STUDENTS
  13. MERCER HUMAN RESOURCE CONSULTING
  14. UNITED STATES DEPARTMENT OF HEALTH AND HUMAN SERVICES
  15. HUMAN RESOURCE SERVICES FOR EMPLOYERS
  16. AUSTRALIAN HUMAN RESOURCE INSTITUTE
  17. HUMAN RESOURCES DEVELOPMENT CANADA
  18. NATIONAL HUMAN RESOURCE ASSOCIATION
  19. INTERNATIONAL PUBLIC MANAGEMENT ASSOCIATION FOR HUMAN RESOURCES
  20. HUMAN RESOURCES FOR HEALTH
  21. WEST VIRGINIA DEPARTMENT OF HEALTH & HUMAN RESOURCES
  22. PROVINCE OF BRITISH COLUMBIA
  23. HUMAN RESOURCES PROFESSIONALS ASSOCIATION OF ONTARIO
  24. CPS HUMAN RESOURCE SERVICES


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It is important that all the hospital staff have the required basic training for doing the job. Such training is recognized as essential for the ophthalmologist and to some extent for the paramedical staff. As far as the others are concerned, the general feeling is that they will learn on the job. While this could theoretically happen, in reality it is often up to the employee to develop the skills on a trial and error method. Inthe process, the quality of their work suffers and this is one of the reasons for wide disparity in quality between programmes. We have provided you the link of various websites which provide Ophthalmic training to various cadres.
  1. A MODEL FOR DEVELOPING A TRAINING CURRICULUM
    Abstract:
    This article aims to share the process involved for the development of a curriculum whilst designing a training programme.

  2. CAN WE TRAIN COMMUNITY WORKERS TO SCREEN FOR PAEDIATRIC OCULAR DISORDERS
    Abstract:
    This article focuses on developing an appropriate model for community-based eye care service delivery to children aged 15 years or younger residing in Kariapatti- a rural block of Virudhanagar district of Tamil Nadu state in India.

  3. OPHTHALMIC NURSING MANUAL
    Abstract:
    This manual for Ophthalmic nursing provides information on all aspects of nursing that one should follow in their day to day activities.

  4. TRAINING AND HUMAN RESOURCES REQUIRED FOR SETTING UP A PAEDIATRIC EYE CARE UNIT
    Abstract:
    This worksheet provides details on the number of eye care personnel needed for each area of a Paediatric Eye Care unit. Also this provides the training requirement for the human resources involved in Paediatric eye care service delivery, and eligibility criteria for an eye hospital to start a Paediatric unit of their own.

  5. TRAINING OPHTHALMOLOGISTS FOR CHILDREN’S EYE CARE CENTRES
    Abstract:
    This article focuses the need for training ophthalmologists in Childhood problems with the objectives of the course, training format to followed, evaluation format etc.

  6. STUDY ON THE STATUS OF OPHTHALMIC MEDICAL EDUCATION IN THE SOUTH - EAST ASIA REGION - AN OVERVIEW
    Abstract:
    This document accounts the study conducted in the South East Asian region on the training, quality of Ophthalmic traning available, technical and managerial skills imparted by the training etc. for policy orientation regarding development of ophthalmic workface in the region.

  7. AN ASSESSMENT OF SKILLS OF MID-LEVEL OPHTHALMIC PERSONNEL (MLOP) IN INDIA
    Abstract:
    This articles reports findings from a study conducted to assess the confidence levels of MLOP relating to the functions they were trained for and to obtain the viewpoints of the chief ophthalmologists of selected institutions on the skills of MLOP.

  8. WORKSHOP ON CURRICULUM DEVELOPMENT FOR TRAINING IN COMMUNITY OPHTHALMOLOGY
Institutions Providing Training for Mid Level Ophthalmic Personnel

We have provide you with the list of various eye care institutions and websites in eye care which provide useful Training programmes.
  1. THE INTERNATIONAL CENTRE FOR EYECARE EDUCATION
    Abstract:
    This article provides a few glimpses of International Centre for Eyecare Education activities.

  2. DIRECTORY OF TEACHING AND INFORMATION RESOURCES FOR BLINDNESS PREVENTION AND REHABILITATION
    Abstract:
    Provides greater information on the resources available for the rehabilitation and blindness prevention from 27 organizations.
List of Institutions Offering Optometric CoursesSome Websites which Provide Useful Training Details Centres For Community Eye Health Training Online Education


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  1. CHALLENGES IN GETTING HUMAN RESOURCES IN EYE CARE
    Abstract:
    This article focuses on Challenges in Getting Human Resources in Eye Care in regions of Africa, Asia and Europe and suggestions to over come this.

  2. CHALLENGES FOR HUMAN RESOURCES IN EYE CARE IN THE CONTEXT OF SOUTH AMERICA
    Abstract:
    An analysis of current situation in Latin-American Countries is discussed in this article.

  3. ATTRACTING AND RETAINING TRAINED OPHTHALMIC PERSONNEL IN A REMOTE, RURAL SETTING
    Abstract:
    This article focuses on how Sadhguru Nethra Chikitsalaya was able to attract and retain trained ophthalmic personnel in remote setting.

  4. TRAINING OF OPHTHALMIC PARAMEDICAL WORK FORCE - CURRENT CHALLENGES IN BANGLADESH
    Abstract:
    One of the Current challenges in Bangladesh is Training of ophthalmic paramedical work force. This article focuses on initiative taken by BNSBto develop Ophthalmic Paramedic Training also it has aims and objective of the course.

  5. HRD FOR MIDDLE LEVEL EYE-CARE WORKERS IN EASTERN AFRICA
    Abstract:
    This article contains report on Human Resources Development for middle level eye-care workers in Eastern Africa. This also contains summarises HRD in Tanzania and Ethiopia as discussed in the workshops, as well as data provided by the participants from Malawi, Zambia and Uganda.

  6. IMPLEMENTING COMPREHENSIVE EYE SERVICES - THE EXPERIENCE IN IRINGA, TANZANIA
    Abstract:
    This article discusses about the Comprehensive Eye Services done in Iringa and Tanzania

  7. TRACHOMA IN THE GAMBIA
    Abstract:
    Trachoma which accounted for 17% of blindness in The Gambia (1986), was reduced to 5% in 1996 through the efforts of the National Eye Care Programme (NECP). But a door to door survey 1999 and 2000 indicated a reversal in achievements.

  8. CONTROLLING BLINDNESS IN INDIA: ACHIEVEMENTS AND FUTURE CHALLENGES
    Abstract:
    This article focuses on controlling the Blindness in India. Its past, present and future scenario. How it over came the constraints and the keys to success is discussed.

  9. TRACHOMA PROGRAM ACHIEVES MAJOR SUCCESS IN MOROCCO AND TANZANIA
    Abstract:
    This article fosuces on the success of International Trachoma Initiative (ITI) pilot projects in Morocco and Tanzania.

  10. CREATING A HIGH RETENTION WORKFORCE IN EYE CARE
    Abstract:
    This article focus on various issues faced by different regions of the world relating to retention of work force and How they over come it.


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The American Academy of Ophthalmology is the largest membership association of Eye M.D.s. Eye M.D.s are ophthalmologists, medical doctors who provide comprehensive eye care, including medical, surgical and optical care. More than 90 percent of practicing U.S. Eye M.D.s are Academy members, and the Academy has more than 7,000 international members. Its mission is to advance the lifelong learning and professional interests of ophthalmologists (Eye M.D.s) to ensure that the public can obtain the best possible eye care. It also provides a wealth of resource for training ophthalmic personnel both on the administrative side as well as on the paramedical side.

Contact Address
American Academy of Ophthalmology
P.O. Box 7424
San Francisco, CA 94120-7424
Tel: 415.561.8500
Fax: 415.561.8533
WebSite:www.aao.org
  1. October 2005 - Ophthalmic Equipment and Instruments
  2. September 2005 - IEC
  3. August 2005 - Start up eye Hospital
  4. July 2005 - Refractive Error
  5. June 2005 - Low Vision
  6. May 2005 - Cataract
  7. April 2005 - Paediatric Eye Care Service Delivery
  8. March 2005 - Strategic Planning Tools
  9. February 2005 - Frequently Asked Questions on Eye Glasses!
  10. January 2005 - Refractive Error Service Resources
  11. December 2004 - Highlighting Starting a New Eye Hospital Tool
  12. November 2004 - Diabetic Retinopathy Knowledge, Attitude and Practice Study
  13. October 2004 - Strategy worksheet for continually improving quality of services and checklist
  14. September 2004 - Quality Cataract Series - Paramedical Contributions Module
  15. August 2004 - Sterilization Protocol
  16. July 2004 - Medical Records Protocol
  17. June 2004 - Magnitude of Cataract Blindness Estimation Tool
  18. May 2004 - Cataract Frequently Asked Questions
  19. April 2004 - Introduction to SiteNews
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