Evaluation of the first 5 years of a national eye health programme in Vanuatu.

Purpose: To evaluate against its objectives the achievements of the first 5 years of a national eye health programme in Vanuatu.

Methods: Programme clinical activity data were collated from surgical logs, clinic and outreach reports, and patient register books. Cataract surgical outcomes were retrieved from monitoring software. Programme annual reports provided information about management, infrastructure improvements, equipment supplied, repaired or replaced, the supply and use of consumables, and human resource development and deployment. Costs were determined from project budgets and acquittals.

Results: The programme promoted eye health, including through the integration of eye care into existing health services; established adequate facilities, at referral hospitals, provincial hospitals and rural health clinics, with equipment and manpower to provide eye care appropriate to the location; established a primary eye care programme; strengthened cataract services, although its effect on any cataract backlog is unknown; developed a diabetic eye disease diagnosis and treatment service, but its reach and effectiveness are unknown; provided accessible comprehensive eye care, but its effect on the prevalence of vision impairment is unknown; and established medical records and data collection systems, but these need more attention.

Discussion: This programme achieved much. However, the evaluation highlighted the limitations of inadequate project design and that, without addressing further human resource development and the Ministry of Health's wavering financial commitment, there are potential risks to ongoing services. That revenue generating capacity was not incorporated into this programme may prove to be a flaw that will limit ongoing access to eye care, especially in rural areas.