Democratising access to world-class eye care | The Financial Express

Democratising access to world-class eye care

Equitable distribution of healthcare and timely access to these services is important and democratization of healthcare is the need of the hour.

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Though rural India constitutes approximately 65% of the total population, it is home to only 33% of all health workers. (File)

By Dr. Arun Singhvi

The field of healthcare is growing ever more complex by the day. Advances in medical technology and increasing digitization are transforming diagnosis, treatment and the delivery of care at a rapid pace. The number of specialists trained in advanced medicine is also seeing a rise. However, the impact of these advances in medicine is urban-centric and visible in the big metros and urban areas and not in the small towns and rural parts of the country. Though rural India constitutes approximately 65% of the total population, it is home to only 33% of all health workers. Overall, around 80% of health infrastructure and resources are concentrated in urban areas where only 35% of the population lives.

The urban-rural divide

Over the decades, this led to a discrepancy in health resources between rural and urban India depriving the rural population of access to quality healthcare. When it comes to major illnesses, rural areas suffer from a lack of easy access to advanced treatment and diagnostic facilities. Equitable distribution of healthcare and timely access to these services is important and democratization of healthcare is the need of the hour.

The rural-urban disparity is seen even more starkly in ophthalmology with the majority of the eye care providers situated in urban areas. This creates challenges for patients in small towns and villages to reach out for eye care. Addressing this disparity is critical. India has an estimated 4.95 million blind persons and 70 million vision-impaired persons. The economic burden of this is immense with an estimated net loss of gross national income due to blindness coming to INR 845 billion. The way forward is early detection and timely treatment to reduce the prevalence of blindness and vision impairment through easy access to advanced eye care facilities.

Need for investment in Eye Care Facilities

Eye camps set up from time to time are restricted in the conditions that can be treated and face challenges in maintaining the quality of care. While outreach camps and primary care centres in rural areas run mainly by the government and nonprofit sector (NGOs) can tackle diseases like cataracts and refractive errors to some extent, there are eye conditions such as diabetic retinopathy, age-related macular diseases and glaucoma that are on the rise due to an ageing population and an increase in lifestyle diseases like diabetes and hypertension. These conditions require specialized diagnosis and treatment in high-quality comprehensive advanced eye care facilities with long-term follow-up care.

What we require are permanent facilities that offer easy access to quality affordable advanced eye care. It is here that the private healthcare sector can contribute by investing in building advanced eye care facilities in Tier 2 and Tier 3 towns. This will go a long way in addressing the needs of patients who otherwise have to travel long distances to big metro cities for treatment at specialized eye facilities. Ease of access to integrated eye care facilities will ensure that vision problems are detected early and timely treatment instituted to prevent deterioration of vision leading to blindness.

As the costs of setting up infrastructure in the smaller towns are lower than in the big cities, the cost of the treatment can also be at levels affordable to the rural population. A beginning has been made with private eye care hospitals focusing on smaller towns and setting up modern eye care facilities in these areas. These facilities are equipped with the latest cutting-edge equipment for diagnosis as well as medical and surgical eye care services for various eye diseases.

Creating a pool of trained eye care professionals

The private sector is also addressing another challenge to making eye care accessible to all and that is the dearth of trained eye care professionals. There is a need for trained, qualified ophthalmologists to meet a population’s eye care needs. While there are over 232,000 ophthalmologists worldwide, there is a significant shortfall in developing countries where the ageing population that needs eye care is growing faster than the profession.

The average ophthalmologist-to-population ratio in developed countries is around 39 ophthalmologists per million population. India with an estimated 25,000 ophthalmologists has just around 15 per million population. However, the urban-rural disparity exists here too with urban areas having one ophthalmologist for 10,000 people with rural areas far behind at one for every 250,000 people. There is a critical need to train more eye specialists with the private sector supported by the government creating standardized training and accreditation programs. Today, many private eye care facilities are offering fellowships and training doctors in specialized areas of ophthalmology. We can leverage existing practices at district levels under an umbrella of SOPs (standard operating procedures) and combine technology and digitisation to create an omnichannel model to maximise patient benefit and reduce the cost of treatment. More trained ophthalmologists will also support the creation of a doctor-led patient care model.

An eye specialist with extensive training and expertise can play a key role in the doctor-led model. The use of digital technology and telemedicine can help patients in remote areas access expert advice guided by local primary health workers. Training primary care health workers in the initial evaluation of a patient can help in managing care coordination with referral to an advanced care centre for further diagnosis and treatment as required. They can also play an important role in counselling and educating patients to overcome their fears of safety and go in for treatment.

India with the world’s largest population of vision-affected individuals is today known as the blind capital of the world. Building eye care facilities and infrastructure backed by trained eye specialists will democratize access to eye care and help to change this!

(The author is a Chairman and Managing Director, ASG Hospital Private Limited. The article is for informational purposes only. Please consult medical experts and health professionals before starting any therapy, medication and/or remedy. Views expressed are personal and do not reflect the official position or policy of the

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First published on: 22-01-2023 at 11:00 IST