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Differences between national and district planning

Article looking at the differences between a VISION 2020 national and district plan.
The national eye care programme should be made up of separate district programmes
© Victoria Francis/LSHTM CC-BY NC

This article is adapted from: The National Eye Health Coordinator Manual. International Agency for Prevention of Blindness, 2011.

National vs district level in VISION 2020

It is important to make the distinction between a VISION 2020 national plan and a VISION 2020 district plan.

National planning has several purposes. It:

  • Helps to solidify the commitment made by the Ministry of Health towards the prevention of blindness
  • Provides an opportunity to gather the stakeholders and develop a consensus on the priorities for the prevention of blindness in the country
  • Supports the development of collaborative relationships amongst stakeholders.

In contrast, a VISION 2020 district plan addresses the implementation of an eye care programme in an administrative area of between about 0.5 and 2 million population. Such units may have a variety of names in different countries, for example regions, provinces, subdistricts or districts.

Table 1. National plans vs district plans

National plans include: District plans include:
National policies Current assessment of service delivery, staffing levels, equipment and instruments
National training initiatives and plans to improve capacity Targets for service delivery (e.g., cataract surgeries, spectacles dispensed)
Recommended staffing at different levels of service delivery Activities needed to achieve each of the targets
National reporting guidelines Plans for improving partnership and identifying new partners
National advocacy Routine monitoring & reporting
Desired equipment and instrument norms Coordination at the district level
Disease priorities (and basic strategies) Time frame for each activity
National procurement of consumables Budget
National supervisory structures
Overall national targets for service delivery
National coordination

National planning

National planning must be open and transparent. Excluding certain people or organisations may cause resentment and the loss of valuable input. Nonetheless, national planning is often best organised by getting a small group of very experienced people together to make the first draft which can be sent around to a wider group of people for comment.

By the time of the national planning meeting, the draft should be virtually finished and most people coming to the meeting should already have provided their input. It is very helpful to have an external facilitator at the meeting who is an expert on VISION 2020 and planning.

District planning

District planning is organised differently to national planning. Much of the writing of the district plan is done during the planning session, using information collected ahead of time. The planning session should follow these basic steps:

  • Review the current situation
  • Discuss practical and desirable targets that will, with time, enable the team to reach their VISION 2020 goal
  • Set 3-4 targets for service delivery. For each target decide on the specific activities needed to achieve the target
  • Determine who will be responsible for each activity and when it will be done.

Pre-planning activities are essential

All planning, whether at national or district level, starts by considering the current situation. It is essential to devote sufficient time to pre-planning. Meeting to plan without having baseline evidence and information to hand is a waste of everyone’s time.

Information to generate before planning session

National planning District planning
Current human resources policies Current service delivery for priority conditions
Current training capacity Cataract surgeries
Current status of procurement of medicines and consumables Presbyopic spectacles
Scientific evidence that could assist with planning of services Childhood cataracts operated
Current service delivery by district using key indicators Glaucoma surgeries
Diabetic retinopathy patients screened
Human resources
Equipment (working or not)
Partners e.g. NGOs, companies


How would you respond to the following questions?

  • Why is it important to make a distinction between a VISION 2020 national plan and a VISION 2020 district plan?
  • How can the relevance of a national plan be maintained when planning for change at a smaller, or district, level?
  • Why is it essential to devote sufficient time to pre-planning before a planning meeting?
© International Agency for Prevention of Blindness
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