School Eye Health in Nigeria: The Situation Now and the Way Forward
Keywords:
teachers, uncorrected refractive errors, visual impairment, blindness, school eye health, School childrenAbstract
There is a strong link between children’s visual health and the quality of their learning and educational achievement. Any problems with their vision can produce many years of living with blindness and vision impairment if not addressed promptly and properly which can in turn affect their future, their quality of life and have an impact on their economic productivity. This can be adequately addressed by putting in place a sustainable school eye health programme strengthened by a viable referral system. School eye health programmes provide a unique opportunity to deliver comprehensive eye health services to school-going children especially when supported by a monitoring and evaluation feedback system. In Nigeria, even though there are pockets of areas where this has been carried out irregularly in the past, this is not yet a widespread practice due to logistic, manpower challenges and poor political will. Currently school eye health programmes appear to be non-existent in this country. The outlook is worse for out-of-school children, of which Nigeria has the largest number worldwide. The focus of this article is to discuss how to achieve and sustain effective school eye health programmes.
References
United Nations Convention on the Rights of the Child. Www.ohchr.org/EN/ professionalinterest/Pages/CRC.aspx
Allison MA, Attisha E; COUNCIL ON SCHOOL HEALTH. The Link Between School Attendance and Good Health. Pediatrics. 2019 Feb;143(2): e20183 648. Doi: 10.1542/peds.2018-3648. PMID: 30835245.
Basch CE. Healthier students are better learners: a missing link in school reforms to close the achievement gap. J Sch Health. 2011 Oct;81(10):593-8. Doi: 10.1111/j.1746-1561.2011.00632.x. PMID: 21923870.
Courtright P, Hutchinson AK, Lewallen S. Visual impairment in children in middleand lower-income countries. Arch Dis Child. 2011 Dec;96(12):1129-34. Doi: 10.1136/archdischild-2011-300093. Epub 2011 Aug 24. PMID: 21868404.
Darge HF, Shibru G, Mulugeta A, Dagnachew YM. The Prevalence of Visual Acuity Impairment among School Children at Arada Subcity Primary Schools in Addis Ababa, Ethiopia. J Ophthalmol. 2017;2017:9326108. Doi: 10.1155/2017/9326108. Epub 2017 Jun 19. PMID: 28706737; PMCID: PMC5494567.
Solebo AL, Teoh L, Rahi J. Epidemiology of blindness in children. Arch Dis Child. 2017 Sep;102(9):853-857. Doi: 10.1136/ archdischild-2016-310532. Epub 2017 May 2. Erratum in: Arch Dis Child. 2017 Oct;102(10):995. PMID: 28465303.
Langford R, Bonell CP, Jones HE, Pouliou T, Murphy SM, Waters E, Komro KA, Gibbs LF, Magnus D, Campbell R. The WHO Health Promoting School framework for improving the health and well-being of students and their academic achievement. Cochrane Database Syst Rev. 2014 Apr 16; (4): CD0 08958. Doi: 10.1002/14651 858. CD0 08958.pub2. PMID: 24737131.
Khanna, Rohit & Gudlavalleti, Murthy. (2017). Importance of integrating eye health into school health initiatives. Community eye health. 30. S3-S5.
National School eye health guidelines; Federal Ministry of Health Nigeria 2020. 10. World Health Organisation. Vision 2020, The right to sight: Global initiative for the elimination of avoidable blindness. Action Plan 2007; 2006-2011.
Huh GJ, Simon J, Grace Prakalapakorn S. Causes of childhood blindness in Ghana: results from a blind school survey in Upper West Region, Ghana, and review of the literature. Int Ophthalmol. 2018 Aug;38(4):1415- 1423. Doi: 10.1007/s10792-017-0600-9. Epub 2017 Jun
PMID: 28612329; PMCID: PMC5729053.
Kehinde S.C. Ogwurike U.V. Eruchalu, E. Samaila.School eye health screening in Kaduna-Northern Nigeria.2005 Nigerian Journal of Surgical Research 7(1):191- 194 DOI: 10.4314/njsr.v7i1.12276.A.V.
n.a. (2008, November 3) Walk for Sight – Standard Chartered Bank Nigeria’s “Seeing is Believing’Initiative: https:// www.sc.com/ng/news-media/2008-walk-for-sight-standard-chartered-banknigerias-seeing-is-believing-initiative/. Last accessed 13th July 2021.
Ebri A. (2019, September 2) Effective school eye health strategy in Nigeria: https://www.iapb.org/news/effectiveschool-eye-health-strategy-in-nigeria/.(Last accessed 13th July 2021).
n.a. (2017, July 25) Nigeria has the ‘’largest number of out-of-school’’ children in the world. https://www. bbc.com/news/world-africa-40715305. (Last accessed 13th July 2021)
Obiezu T. (2021, March 22) Officials say more than 3 million children are out of school in Nigeria.voanews.com/africa/officials-say-more-3-million-children-areout-school-nigeria(Last accessed 13thJuly 2021)
Obiezu T.( 2018, December 18) Nigeria has world’s largest number of out-of-school children. https://www.globalcitizen.org/en/content/un-nigeria-13-million-children-out-of-school/? template=next (Last accessed 13th July2021)
Zhang JH, Ramke J, Mwangi N, Furtado J, Yasmin S, Bascaran C, Ogundo C, Jan C, Gordon I, Congdon N, Burton MJ. Global eye health and the sustainable development goals: protocol for a scoping review. BMJ Open. 2020 Mar 18;10(3):e035789. Doi: 10.1136/bmj open-2019-035789. PMID: 32193 274; PMCID: PMC7202701.
Gilbert C, Murthy GV. The Sustainable Development Goals and Implications for Eye Health Research. Ophthalmic Epidemiol. 2015;22(6):359-60. Doi: 10.3109/09286586.2015.1104365. PMID: 26653258
Stevens GA, White RA, Flaxman SR, Price H, Jonas JB, Keeffe J, Leasher J, Naidoo K, Pesudovs K, Resnikoff S, Taylor H, Bourne RRA; Vision Loss Expert Group. Global prevalence of vision impairment and blindness: magnitude and temporal trends, 1990-2010. Ophthalmology.
Dec;120(12):2377-2384. Doi: 10.1016/j.ophtha.2013.05.025. Epub 2013 Jul 10. PMID: 23850093.
WHO’s mission for vision. Afr Health. 1998 Jul;20(5):38. PMID: 12294120.
Holden BA, Fricke TR, Wilson DA, Jong M, Naidoo KS, Sankaridurg P, Wong TY, Naduvilath TJ, Resnikoff S. Global Prevalence of Myopia and High Myopia and Temporal Trends from 2000 through 2050. Ophthalmology. 2016 May; 123 (5):1036-42. Doi: 10.1016/j.ophtha. 2016.01.006. Epub 2016 Feb 11. PMID: 26875007.
Bourne RR, Stevens GA, White RA, Smith JL, Flaxman SR, Price H, Jonas JB, Keeffe J, Leasher J, Naidoo K, Pesudovs K, Resnikoff S, Taylor HR; Vision Loss Expert Group. Causes of vision loss worldwide, 1990-2010: a systematic analysis. Lancet Glob Health. 2013 Dec;1(6):e339-49. Doi: 10.1016/S2214-109X(13)70113-X. Epub 2013 Nov 11. PMID: 25104599.
Jose R, Sachdeva S. School eye screening and the National Program for Control of Blindness. Indian Pediatr. 2009 Mar;46(3):205-8.PMID:193 46567
Olusanya BA, Ugalahi MO, Ogunleye OT, Baiyeroju AM. Refractive errors among children attending a tertiary eye facility in Ibadan, Nigeria: Highlighting the need for school eye health programs. Ann Ib Postgrad Med. 2019 Jun;17(1):49-59. PMID: 31768156; PMCID: PMC6871198
Ajaiyeoba AI, Isawumi MA, Adeoye AO, Oluleye TS. Pattern of eye diseases and visual impairment among students in southwestern Nigeria. Int Ophthalmol. 2007 Oct;27(5):287-92. Doi: 10.1007/ s10792-007-9056-7. Epub 2007 Jun 22. PMID: 17585376.
Osunde EA, Raymond O, Adio AO. Refractive errors among a young population in an urban secondary school in south-southern Nigeria. PMJ 2010; 4(3):228-236.
n.a. Advancing children’s rights and equality for girls in more than 75 countries. https://plan-international. org/girls-get-equal. Last accessed 10th July 2021.
Fricke TR, Holden BA, Wilson DA, Schlenther G, Naidoo KS, Resnikoff S, Frick KD. Global cost of correcting vision impairment from uncorrected refractive error. Bull World Health Organ. 2012 Oct 1;90(10):728-38. Doi: 10.2471/BLT.12. 104034.Epub 2012 Jul 12. PMID: 2310
; PMCID: PMC3471057.
Smith TS, Frick KD, Holden BA, Fricke TR, Naidoo KS. Potential lost productivity resulting from the global burden of uncorrected refractive error. Bull World Health Organ. 2009 Jun;87(6):431-7. Doi: 10.2471/blt.08.055673. PMID:1956512 1; PMCID: PMC2686211.
Rahi JS, Gilbert CE, Foster A, Minassian D. Measuring the burden of childhood blindness. Br J Ophthalmol. 1999 Apr;83(4):387-8. Doi: 10.1136/bjo.83.4. 387.PMID:10434856;PMCID: PMC 172 3010.
n.a. (2018 June 28) ‘’ECCE :All children everywhere Innovate, Participate, Collaborate’’ https://www.childtochild. org.uk/news/ecce-all-children-everywhere-innovate-participate-collaborate/ Last accessed June 15th 2021.
Paudel P, Yen PT, Kovai V, Naduvilath T, Ho SM, Giap NV, Holden BA. Effect of school eye health promotion on children’s eye health literacy in Vietnam. Health Promot Int. 2019 Feb 1; 34(1): 113-122. Doi: 10.1093/heapro/dax065. PMID: 29040581.
Marshall EC, Meetz RE, Harmon LL. Through our children’s eyes—the public health impact of the vision screening requirements for Indiana school children. Optometry. 2010 Feb;81(2):71- 82. Doi: 10.1016/j.optm.2009.04.099. PMID: 20152780.
Vongsachang H, Friedman DS, Inns A, Kretz AM, Mukherjee MR, Callan J, Wahl M, Repka MX, Collins ME. Parent and Teacher Perspectives on Factors Decreasing Participation in SchoolBased Vision Programs. Ophthalmic Epidemiol. 2020 Jun;27(3):226-236. Doi: 10.1080/09286586.2020.1730910. Epub 2020 Feb 20. PMID: 32079450
Ayanniyi AA, Olatunji FO, Mahmoud AO, Ayanniyi RO. Knowledge and attitude of guardians towards eye health of primary school pupils in Ilorin, Nigeria. Niger Postgrad Med J. 2010 Mar;17(1):1-5. PMID: 20348974.
Morjaria P, Evans J, Murali K, Gilbert C. Spectacle Wear Among Children in a School-Based Program for Ready-Made vs Custom-Made Spectacles in India: Randomised Clinical Trial. JAMA Ophthalmol. 2017 Jun 1;135(6):527- 533. Doi: 10.1001/jamaophthalmol. 2017.0641 Congdon et al. 2008; Pavithra et al. 2014
Priya A, Veena K, Thulasiraj R, et al. Vision screening by teachers in Southern Indian schools: Testing a new “all class teacher” model. Ophthalmic Epidemi ology 2015; 22:60-65.
Sudhan A, Pandey A, Pandey S, et al. Effectiveness of using teachers to screen eyes of school-going children in Satna district of Madhya Pradesh, India. Indian Journal of Ophth. 2009; 57:455-458.
du Toit R, Faal HB, Etya’ale D, Wiafe B, Mason I, Graham R, Bush S, Mathenge W, Courtright P. Evidence for integrating eye health into primary health care in Africa: a health systems strengthening approach. BMC Health Serv Res. 2013 Mar 18;13:102. Doi: 10.1186/1472-
-13-102. PMID: 23506686; PMCID:PMC3616885.
Aghaji A, Burchett HED, Mathenge W, Faal HB, Umeh R, Ezepue F, Isiyaku S, Kyari F, Wiafe B, Foster A, Gilbert CE. Technical capacities needed to implement the WHO’s primary eye care package for Africa: results of a Delphi process. BMJ Open. 2021 Mar 19;11(3):e042979. Doi: 10.1136/bmj open-2020-042979. PMID: 33741664; PMCID: PMC7986885.
Adio AO. The Pediatric ophthalmology service of the University of Port Harcourt Teaching Hospital, Rivers State- A reflection of a neglected area in health care delivery. Int J Trop Surg 2010; 4(2) : 78-80.
World Health Organization. Strategies for the prevention of blindness in National Programmes: A primary health care approach vol. WHO document WHO/ PBL/83.3. Geneva: World Health Organization; 1997. [Google Scholar]
Standard Guidelines for Comprehensive School Eye Health Programmes (PDF, 4 MB). Available on this page: http://iceh.lshtm.ac.uk/files/2014/07/ Standard-Guidelines-for-Comprehensive-School-Eye-Health-Programs. compressed.pdf
World Health Report: Health Systems. Improving Performance. 2000.
Chandna A, Gilbert C. When your eye patient is a child. Community Eye Health. 2010 Mar;23(72):1-3. PMID: 20523854; PMCID: PMC2873665.