Visual health screening by schoolteachers in remote communities of Peru: implementation research/Depistage des troubles visuels par des enseignants dans des communautes isolees du Perou: recherche sur la mise en oeuvre/Examenes de la salud visual realizados por profesores de escuela en comunidades remotas de Peru: investigacion sobre la ejecucion

• Published in: Bulletin of the World Health Organization 2016-09, Vol.94 (9), p.652-652
• Main Authors: Latorre-Arteaga, Sergio, Gil-Gonzalez, Diana, Bascaran, Covadonga, Nunez, Richard Hurtado, Morales, Maria del Carmen Peral, Orihuela, Guillermo Carrillo
• Format: Article
• Language: English
• Subjects: Adaptation to change; Blindness; Children & youth; Collaboration; Colleges & universities; Families & family life; International relations; Intervention; Medical personnel; Medical screening; Parents & parenting; Peru; School effectiveness; School principals; Teachers; Visual impairment
• ISSN: 0042-9686
• DOI: 10.2471/BLT.15.163634

To describe the adaptation and scaling-up of an intervention to improve the visual health of children in the Apurimac region, Peru. In a pilot screening programme in 2009-2010, 26 schoolteachers were trained to detect and refer visual acuity problems in schoolchildren in one district in Apurimac. To scale-up the intervention, lessons learnt from the pilot were used to design strategies for: (i) strengthening multisector partnerships; (ii) promoting the engagement and participation of teachers and (iii) increasing children's attendance at referral eye clinics. Implementation began in February 2015 in two out of eight provinces of Apurimac, including hard-to-reach communities. We made an observational study of the processes and outcomes of adapting and scaling-up the intervention. Qualitative and quantitative analyses were made of data collected from March 2015 to January 2016 from programme documents, routine reports and structured evaluation questionnaires completed by teachers. Partnerships were expanded after sharing the results of the pilot phase. Training was completed by 355 teachers and directors in both provinces, belonging to 315 schools distributed in 24 districts. Teachers' appraisal of the training achieved high positive scores. Outreach eye clinics and subsidies for glasses were provided for poorer families. Data from six districts showed that attendance at the eye clinic increased from 66% (45/68 children referred) in the pilot phase to 92% (237/259) in the implementation phase. Adaptation to the local context allowed the scaling-up of an intervention to improve visual health in children and enhanced the equity of the programme./Decrire l'adaptation et l'extension d'une campagne visant a ameliorer la sante visuelle des enfants dans la region d'Apurimac, au Perou. Dans le cadre d'un programme pilote de depistage mene dans un district de la region d'Apurimac en 2009-2010, 26 enseignants avaient ete formes pour realiser un depistage de l'acuite visuelle chez les enfants scolarises et orienter les enfants presentant des troubles visuels vers un centre de soins. Dans le but d'etendre cette campagne, les lecons tirees du programme pilote ont ete exploitees pour elaborer des strategies pour: (i) intensifier les partenariats multisectoriels; (ii) promouvoir l'implication et la participation des enseignants et (iii) augmenter le nombre d'enfants pris en charge dans un centre ophtalmologique. La mise en oeuvre a debute en fevrier 2015, dans deux des hui