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The goal of the Better Vision, Healthy Ageing Program is improved health, vision and quality of life for elders in South and South-East Asia, and increased attention to vision within healthy ageing policies and programs.
“Active ageing is the process of optimising opportunities for health, participation and security in order to enhance quality of life as people age. … Active ageing allows people to realise their potential for physical, social, and mental well-being throughout the life course and to participate in society, while providing them with adequate protection, security and care when they need.”
- World Health Organization
In 2011 The Fred Hollows Foundation, recognising the rapid increase in population ageing, especially in the Asian region, decided to collaborate with the Burnet Institute in a program to evaluate integrated approaches to addressing eye health for older people.
The Sri Lankan Ministry of Health is currently implementing new strategies to prevent and manage the high and rapidly increasing rates of chronic non-communicable diseases and Sri Lanka has an active Vision 2020 program that addresses specific causes of blindness.
In 2011 consultations were conducted in Sri Lanka with key stakeholders. There was great interest and the current Program builds on an earlier healthy ageing project in Nuwara Eliya district, Sri Lanka.
The Better Vision, Healthy Ageing Program aims to explore how to address the existing need for glasses, cataract surgery, and other eye health care services, and to bring eye health services closer to communities by using the platform of Elders’ Clubs for eye screening and health promotion activities.
Rationale
Sri Lanka has one of the fastest ageing populations in Asia. The proportion of elders is now increasing quickly because Sri Lanka achieved longer life expectancy and reduced birth rates soon after independence. In 2015, 12.4 per cent of the population in Sri Lanka was over the age of 60 years; this is estimated to reach 28.6 per cent by 2050. Population ageing is happening at a much faster rate than occurred in richer countries.
Older people contribute significantly to their families and communities in emotional, social and economic ways. But disability and illness undermines their ability to contribute.
Eye health problems, especially cataract and refractive errors, are more common among older people. Globally, more than 82 percent of the estimated 39 million people who are blind are older than 50 years. Women have a higher risk of visual impairment than men.
Recent national survey data shows that the prevalence of blindness in Sri Lanka increases with age: 2.3 per cent aged 50 years and above, 4.0 per cent aged 60 years and over and 8.4 per cent aged over 70 years. There has been a great increase in diabetes, high blood pressure and heart disease. This is the result of new lifestyles and diets, as well as the increasing average age of the population. Diabetes, high blood pressure and heart disease increase the likelihood of eye problems.
The impact of poor vision is greater on older people. They are often poor. They often have to cope with other health problems or disabilities. And they often have difficulties in reaching health care services.
Good sight enables better quality of life and allows older people to continue to play an active role in their families and communities. Social participation protects against many chronic non-communicable diseases and ageing-related conditions.
Poor vision increases the burden of care on families, especially women, and makes it more difficult for older people to prevent and manage their physical and mental health problems. The desire to keep their vision can encourage individuals to prevent and better manage diabetes and high blood pressure.
Most causes of poor vision, such as cataract and lens problems, can be solved with a simple operation or spectacles. A few older people have eye problems that cannot be improved. But they can be helped in other ways to make their lives easier.
There is a need for more attention to eye health by elders, their families, their communities and government services. Investing in healthy ageing and better vision will contribute to achieving the Sustainable Development (SDGs).
The program aims:
Program Components
Component One: Building Capacity for Service Delivery
It is an important principle that research and advocacy programs should be accompanied by service delivery. The program focuses on strengthening capacity for eye health service delivery throughout Nuwara Eliya district, consistent with the strategies of the Vision 2020 National Programme for Prevention and Control of Avoidable Blindness in Sri Lanka (2007–2012).
Component Two: Health Promotion Through Healthy Ageing Strategies
The key strategy for achieving component two is provision of support for establishing community- level Elders’ Clubs. The Elders’ Clubs program provides opportunities to reach elders with vision screening and referral for cataract surgery, glasses or other eye care, and facilitates the discussion of eye health promotion messages. The program has identified, trained and supported peer ‘Eye Health Promoters’ (EHPs), a novel approach to stage one vision screening of elders in the community, and peer education and health promotion. Activities are consistent with the Vision 2020 Sri Lanka National Plan, the Sri Lanka action plan Mobilising commitment and action to address non communicable disease 2011, and the Sri Lanka National Action Plan on Ageing 2011 – 2015.
Component Three: Research
Component Four: National and Regional Advocacy for Vision and Healthy Ageing
Funding for this program is provided by The Fred Hollows Foundation.
July 2012 to June 2015
The Ministry of Health Vision 2020 Program
The Ministry of Social Services
Plantation Human Development Trust
PALM Foundation (lead implementing partner)
Berendina
Sarvodaya
Nuwara Eliya Regional Health Directorate
Kandy Eye Centre, General Hospital, Kandy
Provincial Department of Health Services, Central Province
South Australian Institute of Ophthalmology, ‘Sight for all’
The program is funded by The Fred Hollows Foundation.
Burnet Institute’s Centre for International Health provides technical advice and support and manages the program.
For any general enquiries relating to this project, please contact: