Abstrakt
Aim: to describe the challenges peculiar to Nigeria in the implementation of vision 2020: the right to sight and to proffer solutions as to the way forward
Method: a review of the recently completed national blindness survey, current literature, and the advocacy experience of the Ophthalmological Society of Nigeria.
Findings: the prevalence of blindness in Nigeria is 0.78%. Over 43% of these are blind from cataracts and a further 9% from uncorrected aphakia or complications of couching. 50% of all cataract interventions are carried out by itinerant couchers. Other major causes of blindness are glaucoma (16%) corneal opacities (12%), trachoma (4%), optic atrophy (3%) onchocerciasis (1%) and macular disease (1%). 70% of these are either preventable or reversible. Nigeria has a relatively favourable ophthalmologist/population ratio of about 2.8 per million, but has a low Cataract surgical rate of 300 per million per year. The reasons for this include a lack of ownership of blindness prevention programs, a lack of political will and parlous state of funding for vision 2020. There is an abdication of responsibility for both training and services on the part of government to the International Non-Governmental organisations. Teaching hospitals no longer generate enough patient surgical load to support training. We estimate it would cost N8.5 billion ($56.8 million) to sustain the WHO recommended Cataract Surgical Rate of 3000 per million per year in Nigeria.
Conclusions: Nigeria is not headed in the direction of meeting Vision 2020 targets. Advocacy involving funding through the MDGs, needs to be intensified.
Key words: Blindness prevention, Nigeria, vision 2020.
Résumé
Pour décrire les défis réguliers au Nigeria sur l’implémentation de la vision 2020: le droit à la vision et d’apporter les solutions ; La revue de la surveillance de la cécité national, la littérature courante et l’expérience de la Société Ophtalmologique au Nigeria. Les résultats montrent que le taux de cécité au Nigeria est de 0.78%. Plus de 43% sont cause par les cataractes et en plus de 9% de l’aphasie non corrigée ou complications. 50% des cas d’intervention de cataracte sont faite par des praticiens itinérants. D’autres causes majeurs d’aveuglée sont le glaucome (16%), les opacités cornières (12%), trachome (4%), l’atrophie optique (3%), onchocercose (1%) et la maladie maculaire (1%). 70% des cas étaient preventables ou réversibles. Nigeria a une proportion ophtalmologiste/population relativement favorable d’environ 2.8 par million, mais des taux de chirurgies de cataracte faibles de 300 par million par an. Les raisons de ceci inclus le manque de programmes de prévention de la cécité, manqué de la volonté politique et de fond maigre de l’état de la vision 2020. Il y a un manque de responsabilité dans la formation et les services de la part du gouvernement aux organisations internationales non-gouvernementales. Les centres hospitaliers ne génèrent plus assez de fond des cas de chirurgie pour supporter la formation. Nous estimons un cout de N8.5 billion ($56.8 million) pour supporter les soins de la chirurgie de la cataracte recommandée par OMS de 3000 par millions par an au Nigeria. En conclusion, Le Nigeria, avance pas dans la direction de joindre les objectifs de la vision 2020. La recherche des financements par les MDGs, doit être intensifiée.
Correspondence: Babalola O.E. 23, Onitsha Crescent, Garki, Abuja, Nigeria. E-mail- bablo57@yahoo.com
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