Main Article Content
Background: Alma Ata declaration form the bed rock that link primary health care (PHC) and health promotion to enable individuals and communities to increase control over the determinants of health. The declaration is meant to address the main health problems in the community by providing promotive, preventive, curative and rehabilitative services including visual impairment.
Objective: To evaluate the landmark achievement of eye health promotion for prevention of visual impairment in Nigeria.
Methods: A non-systematic review of published literatures was adopted to develop this narrative review. Literatures searches were done through PubMed, google scholar and biomed central. Search terms included primary eye care (PEC), health promotion and Nigeria. 45 articles were reviewed.
Results: Landmark achievement includes elimination of blinding trachoma and onchocerciasis as a public health problem following the treatment of 120 million people. Evaluation of the collaboration between Sightsavers, UK and the Ministry of Health in Sokoto State (Northern Nigeria) on VISION 2020 – Right to Sight program; showed an increase in the proportion of persons aged 50 years and over without visual impairment from 54.7% in 2005 to 77.3% in 2016. The prevalence of blindness in same age range declined from an estimated 11.6% to 6.8%, severe VI from 14.2% to 4.3% and moderate VI from 19.5% to 11.4%. A reduction in the estimated all‑age blindness prevalence by more than a half from 2.0% in 2005 to approximately 0.75% in 2016 was reported. No known similar evaluation was surveyed in the southern part of Nigeria to the knowledge of the researchers. However, non-integration of eye health promotional policy into PHC have left the Nigerian population in the miry clay of sustained prevalence of avoidable visual impairment.
Conclusion: Alma Ata Declaration called on all governments to formulate national policies, strategies and plans of action to launch and sustain primary healthcare, integration of PEC and eye health promotional policies into PHC system to reduce the public health burden of avoidable visual impairment.
Gofin J. Community oriented primary care and primary health care. American Journal of Public Health. 2005;95:757.
Pascolini D, Mariotti SP. Global estimates of visual impairment: 2010. British Journal of Ophthalmology. 2012; 96:614–8.
Bourne RRA, Flaxman SR, Braithwaite T, Cicinelli MV, Das A, Jonas JB, et al. Magnitude, temporal trends and projections of the global prevalence of blindness and distance and near vision impairment: A systematic review and meta-analysis. The Lancet Global Health. 2017; 5:e888–97.
Gilbert C, Foster A. Childhood blindness in the context of VISION 2020-the right to sight. Bull World Health Organ. 2001;79: 227–32.
Onyekwe L, Ajaiyeoba A, Malu K. Visual impairment among school children and adolescents on Jos Plateau, Nigeria. Nig J Ophth. 1998;6:1–5.
Akano OF. Vision health disparities in blindness and visual impairment in Nigeria: A review of the Nigerian national blindness and visual impairment survey. African Vision and Eye Health 2017;76: a345.
Olalubi O, Bello IS. Community-based strategies to improve primary health care (PHC) services in developing countries. Case study of Nigeria. J Primary Health Care Gen Practice. 2020;4:1–6.
World Health Organization. Formulating strategies for health for all by the year 2000: Guiding principles and essential issues. Document of the executive board of the world health organization. Geneva; 1978.
Khan MMS, Khan M. Development of primary eye care as an integrated part of comprehensive health care. Community Eye Health. 1998;11:24–6.
Dineen B, Gilbert CE, Rabiu M, Kyari F, Mahdi AM, Abubakar T et al. The Nigerian national blindness and visual impairment survey: Rationale, objectives and detailed methodology. BMC Ophthalmology. 2008; 8.
Gilbert C, Murthy G, Sivasubramaniam SS et al. Couching in Nigeria: prevalence, risk factors and visual acuity outcomes. Ophthalmic Epidemiol. 2010;17:269–75.
Abdulrahman AA, Rabiu MM, Alhassan MB. Knowledge and practice of primary eye care among primary healthcare workers in northern Nigeria. Tropical Medicine and International Health. 2015; 20:766–72. Available:https://doi.org/10.1111/tmi.12486
Moyegbone JE, Nwose EU, Nwajei SD, Agege EA, Odoko JO, Igumbor EO. Integration of eye care into primary healthcare tier in Nigeria health system : A case for Delta State. Clinical Medical Reviews and Reports. 2020;3:1–6.
Aghaji A, Gilbert C, Ihebuzor N, Faal H. Strengths, challenges and opportunities of implementing primary eye care in Nigeria. BMJ Glob Health 2018;3: e000846.
Hubley J, Gilbert C. Eye health promotion and the prevention of blindness in developing countries: Critical issues. British Journal of Ophthalmology. 2006;90: 279–84.
World Health Organization. Ottawa charter of Health Promotion. World Health Organization Geneva; 1986.
Scriven A. Promoting health: A global context and rationale. In Scriven A, Garman S (eds). Promoting Health: Global issues and perspective, basingstoke: Palgrave Macmillan; 2005.
Okafor C, Young E, Nwobi A. Health promotion strategies for the prevention and control of non-communicable diseases in Nigeria health promotion strategies for the prevention and control of non-communicable diseases in Nigeria. South American Journal of Public Health. 2016;4:1–10.
Hehir M. Health promotion and the prevention of eye injuries. Community Eye Health. 1997;10:56–7.
Tannahill A. What is health promotion? Health Education Journal. 1985;44:167–8.
Magawa R. Primary health care implementation: A brief review. Public health discussion paper. Consultancy Africa intelligence; 2012.
Olise P. Primary health care for sustainable development. Abuja: Ozege publications; 2007.
Dineen B. Health promotion and community participation in eye care services. Community Eye Health. 1999; 12:35–6.
Ravilla D, Ramasamy D. Advocacy for eye care. Indian J Ophthalmol. 2012;60:376–379.
Obionu CN. Primary health care for developing countries. 2nd ed. Enugu: Delta Publications; 2007.
Cueto M. The origins of primary health care and selective primary health care. American Journal of Public Health. 2004; 94:1864–81.
Rabiu MM, Al-Rajhi A, Qureshi MB, Gersbeck J. Enhancing advocacy for eye care at national levels: What steps to take for the next decade. Middle East African Journal of Ophthalmology. 2012; 19:75–82.
World Health Organization. Universal eye health: A global action plan 2014-2019. World Health Organisation; 2013.
Muhammad N, Adamu M, Mpyet C, Bounce C, Maishanu N, Jabo A et al. Impact of a 10 ‑ year eye care program in Sokoto , Nigeria : Changing pattern of prevalence and causes of blindness and visual impairment. Middle East Afr J Ophthalmol. 2019;26:101–6.
Federal Ministry of Health. Revised national health policy abuja; 2004.
Hopkins A. Onchocerciasis then and now: Achievements, priorities and challenges. Community Eye Health Journal. 2017;30: 92–5.
Abdulraheem IS, Olapipo AR, Amodu MO. Primary health care services in Nigeria: Critical issues and strategies for enhancing the use by the rural communities. Journal of Public Health and Epidemiology. 2012; 4:5–13.
Solomon A, Kurylo E. The global trachoma mapping project. Community Eye Health Journal. 2014;27(85):18.
Muhammad N, Adamu M. Making a difference with vision 2020 : The right to sight ? Lessons from two states of North Western Nigeria. Nigerian Journal of Clinical Practice. 2014;17:723–8.
Ogundimu KO. Case study: Improving the management of eye care programmes. Community Eye Health Journal. 2008;21: 60–1.
Emerson P. The safe strategy for trachoma control: Poised for rapid scale-up. Community Eye Health Journal. 2014; 27:38.
Holland P, Resnikoff S. Beyond vision 2020: Universal eye health coverage and the elimination of trachoma. Community Eye Health Journal. 2019;32:60.
Adeyemo D. Local government and health care delivery in Nigeria: A case study. J Hum Ecol. 2005;18:149–60.
Omoleke II. The primary health care services in Nigeria: Constraints to optimal performance. Niger J Med. 2005;14:206–12.
Uzochukwu BSC, Ughasoro MD, Etiaba E, Okwuosa C, Envuladu E, Onwujekwe OE. Health care financing in Nigeria: Implications for achieving universal health coverage. Nigerian Journal of Clinical Practice. 2015;18:437–44.
Aghaji A, Burchett H, Hameed S, Webster J, Gilbert C. The technical feasibility of integrating primary eye care into primary health care systems in Nigeria : Protocol for a mixed methods cross-sectional study. JMIR Res Protoc.
Du Toit R, Faal HB, Etya D, Wiafe B, Mason I, Graham R et al. Evidence for integrating eye health into primary health care in Africa : A health systems strengthening approach. BMC Health Services Research. 2013;13:1–15.
Ackland P. The accomplishments of the global initiative VISION 2020: The right to sight and the focus for the next 8 years of the campaign. Indian Journal of Ophthalmology. 2012;60: 380–6.
Nasir MA, Elsawy F, Omar A, Haque SO, Nadir R. Eliminating trachoma by 2020 : Assessing progress in Nigeria surgery. cureus. 2020;12:e9450.