In this step you begin to use a toolkit to take a practical approach to the 3 key steps of planning district-level diabetic retinopathy (DR) service:
Planning DR services in Ormo district
The toolkit uses our hypothetical case study of Ormo as its reference. You can also download a template of the tool kit and use it for your own setting.
What we know already about diabetes and DR services in Ormo Strengths.
To make a difference, planning must identify and involve all the key stakeholders in the health system. In Ormo, the stakeholders are the Ministry of Health, the local consultant ophthalmologists, the local endocrinologist, the public health expert for Ormo, the INGO working in partnership with the tertiary hospital and representatives from the local health centre and diabetes society.
Step 1: Situation analysis
The purpose of a situation analysis is to provide an evidence-informed basis for:
Using a tool kit to document a situation analysis provides a basis for participatory and inclusive dialogue and an analytical framework to examine the impact of past decisions and keep the focus on the most relevant and important issues. It can also be used when the plan is implemented to represent the impact of the plan across the health system and in the population being served.
The first part of this tool kit addresses two key questions:
A. How big is the need for eye services?
In the community, we serve, how many people need the two main services required to address diabetic retinopathy?
1. Case detection in Ormo
Use the information below to calculate the number of people with diabetes in Ormo. Remember, everyone with diabetes will need to be screened.
Tips: The question marks “???” indicate where to make the calculation. Use the formula provided to do the calculation.
2. Treatment in Ormo
Use the information below to calculate how many people with diabetes in Ormo will need treatment for sight-threatening diabetic retinopathy (STDR).
Information source: From surveys in similar low- and middle-income countries we can estimate that 10% of people with diabetes in Ormo will have sight-threatening diabetic retinopathy.
B. What is the existing situation for DR services
Output indicators provide a measure of what is being done at present and can be obtained from the eye clinics serving the population.