EYE CARE IN AFRICA

The state of eye care in Africa stands in alarming contrast to the rest of the world. Poor practitioner- to-patient ratios, total absence of eye-care personnel, inadequate facilities, poor state funding and a lack of educational programs are the hallmarks of eye care in Africa, with preventable and treatable ocular conditions being the leading causes of blindness.

Africa is one of the worst affected regions of

the world, accounting for almost seven million of the world’s blind population. The eye-care crisis is exacerbated by the high prevalence of HIV-AIDS, which places disproportionate pressure on the health-care system by utilising a high percentage of the limited resources.The extreme paucity of eye-care personnel and infrastructure to train personnel, amplifies the vision care crisis. With an average of one ophthalmologist per one million of the population in the Sub-Saharan African region, the likelihood of adequately addressing this problem in the immediate future is bleak. The number of optometrists being produced in Africa is also insufficient to effectively meet eye-care needs. Only seven of the 53 African countries conduct optometric training programs. To compound the problem of insufficient eye-care personnel, most practising ophthalmologists and optometrists are either in private practice or in urban areas. These practitioners serve only a fraction of the population, with the majority still dependent on the public sector due to their poor income or lack of medical insurance. In South Africa, only 20 percent of the population is served by the private sector. Approximately 2,500 optometrists provide eye care to a population of 44 million people in

South Africa (that is, approximately one optometrist per 17,600 of the population). Comparatively, in the United Kingdom, the ratio is approximately 1 : 5200. When one considers the fact that approximately 2,400 optometrists are serving 20 percent of the population, then the ratio is 13,700 for the private sector and 1 : 352,000 for the public sector. The aggregate population to practitioner ratios mask the intra-country differences that occur and the distinction between the poor who rely on government services and those who can afford private services. In many instances, eye-care service delivery relies heavily on the presence and participation of ophthalmic nurses, ophthalmic clinical officers and other health-care personnel.