Refractive error and school health in India

In this step Dr G.V.S. Murthy, Director of the Public Health Foundation of India, gives a brief overview of the development, successes, and challenges of India’s ambitious national programme for school vision testing which has screened more than 25 million children for refractive errors to date.

He highlights the key steps taken to establish a clear rationale for the cut off for the vision screening test, and demonstrates the VA card that is used by school teachers across India.

The successes of the Indian school vision testing programme include:

1. High coverage with over 25 million children (aged 10-14 years) screened across the country
2. The programme is fully supported by the Indian Government and includes spectacle provision
3. The vision testing programme uses a standardised methodology and the simple protocol is easily understood by teachers and students
4. The programme has enabled the development of strong referral mechanisms and inter-sectoral co-operation between the Department of Education and Department of Health.

The challenges that the programme is faced with include:

1. The programme serves a very large population and therefore monitoring quality of screening and spectacles remains an issue that needs to be strengthened
2. At present the programme is fully dependant on government support and sustainability would be an issue if this is withdrawn.

Discussion

Funding vision testing programme is essential for equity and sustainability. What are the options available in your setting or as experienced in your practice?