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WCO speaker: Imbalance between advancing scope, creating access
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CHICAGO – A speaker here at the World Council of Optometry urged optometrists around the world to focus more on access to eye care in underserved areas than on legislating scope of practice.
“We marginalize ourselves, focusing more on politics and less on public health,” Kovin Naidoo, OD, PhD, MPH, told attendees from more than 20 countries. “The language that has been most attractive is the language of creating access and expansion of services. Those who address the needs of the majority get the ear of the legislators. We have an imbalance between our argument for scope advancement and creating access.”
Prof. Naidoo is global programs director for the International Centre for Eyecare Education and Africa Chair for the International Agency for the Prevention of Blindness.
“In South Africa, the question of therapeutics was driven by the board of optometry, not by lobbying the legislators but by making a strong public health argument,” Prof. Naidoo said. “When the decision was made, there was only one optometrist in the room, but the public health argument carried the day. We have shown what we can do and how we can do it."
“When you show what value you can add to the public sector, scope doesn’t matter so much,” he added.
“Be cognizant that we have islands of success while we live in a sea of deprivation,” Prof. Naidoo said. “Our challenge is not the programs we have, but how effectively we can upscale the services needed. We are not just about eyes, but we should be about people and interface with the challenges in the developing world.”
Prof. Naidoo said that 640 million people around the world are blind or visually impaired simply because they do not have a pair of glasses, and $269 billion in productivity is lost in the developing world as a result of uncorrected refractive error.
He said the World Health Organization bulletin just accepted a paper that states that 47,000 extra personnel are needed in refractive care, and 18,000 more in ophthalmic dispensing services.
“Optometry must become more a part of sustainable development,” Prof. Naidoo said, “promoting eye care services but creating sustainable services. The service delivery options in the developing world we should be supporting are partnerships with government, local organizations and local entrepreneurs. We get so caught up in the public health tirade that we forget having a viable private sector is vital to ensuring sustainable eye care services.”
Prof. Naidoo said optometry received a public health boost through VISION 2020.
“In the last few years we’ve seen our profession responding to the universal need for quality, accessible, cost effective eye and vision care,” he said. “We have seen a leadership role in addressing uncorrected refractive error and low vision. We have become catalytic to the development and integration of eye care services.
“It is rare in the developing world that such planning exercises are occurring without optometry being considered,” he continued. “Need should drive scope, not politics.”