Scaling up, scaling down, and sustaining elimination: How the global trachoma program contributes to universal health coverage
In 2002, it was estimated that 1.5 billion people worldwide lived in areas that were endemic for trachoma - the world’s leading infectious cause of blindness. Since then, increased political will and investment have enabled trachoma to be mapped in many areas and the WHO-endorsed SAFE strategy to be scaled up. This has contributed to a 92% reduction in the number of people at risk of trachoma globally, and 18 countries validated by WHO as having eliminated trachoma as a public health problem.
As the global trachoma program continues to evolve, the trachoma community has increasingly recognized that focusing solely on the scale up of interventions can neglect other important considerations, including health equity, sustainability, and the achievement of universal health coverage. As a result, increased efforts are being made to design trachoma public health campaign programs that purposefully work towards health system strengthening, ensure that national health systems are equipped to manage trachoma in particularly vulnerable and hard to reach communities (including indigenous, nomadic and displaced populations), as well as in environments where the prevalence of trachoma is reduced and public health campaign interventions are scaled down.
Human resources for eye health
A key challenge for the sustainability of access to trachoma services is a lack of adequate human resources for eye health. The global trachoma program is supporting national health systems to maintain high quality eye care through several innovations. Notably, in many trachoma-endemic settings, HEAD START, a surgical training simulator, is being used to train surgeons, maintain skills, and build confidence for performing surgery on patients. HEAD START is particularly valuable as it is small and portable, allowing training to take place in remote settings which otherwise might not be able to access high quality training support.
In Ethiopia, the Ministry of Health is currently developing plans to equip secondary and tertiary eye care units with HEAD START to enable eye care workers to practise their skills. This is essential for the maintenance of surgical skills and for maximizing the impact of limited resources. Innovations like HEAD START are complemented by other digital health tools, such as the TT Tracker, which helps surgeons, assistants and supervisors to collect and analyse information about surgical outcomes and performance, and provide additional training when required.
The International Coalition for Trachoma Control (ICTC) celebrates Canada's contribution to support trachoma elimination efforts— PJ Hooper
A key challenge for the sustainability of access to trachoma services is a lack of adequate human resources for eye health. The global trachoma program is supporting national health systems to maintain high quality eye care through several innovations. Notably, in many trachoma-endemic settings, HEAD START, a surgical training simulator, is being used to train surgeons, maintain skills, and build confidence for performing surgery on patients. HEAD START is particularly valuable as it is small and portable, allowing training to take place in remote settings which otherwise might not be able to access high quality training support.
In Ethiopia, the Ministry of Health is currently developing plans to equip secondary and tertiary eye care units with HEAD START to enable eye care workers to practise their skills. This is essential for the maintenance of surgical skills and for maximizing the impact of limited resources. Innovations like HEAD START are complemented by other digital health tools, such as the TT Tracker, which helps surgeons, assistants and supervisors to collect and analyse information about surgical outcomes and performance, and provide additional training when required.