The case of Haiti: building successful and sustainable ophthalmology service at externally funded institution, hospital Albert Schweitzer (HAS) in Artibonite Valley, Haiti

Session Details

Session Title: Orbis Free Paper Session

Session Date/Time: Monday 12/09/2016 | 11:30-12:45

Paper Time: 11:48

Venue: Room B10

First Author: : Y.Zelenski CANADA

Co Author(s): :    D. Eisenmann   J. Cadet                 

Abstract Details

Purpose:

This paper aims to demonstrate effectiveness of blindness promotion program in rural Haiti through establishing of ophthalmology department at HAS, cultivating culture of quality of surgical outcomes and safety, engagement of local pharmaceutical and optical businesses , diversification of services, and sources of co-financing within the five year period, 2010-2015.

Setting:

Ophthalmology department of not-for-profit hospital/corporation- Hospital Albert Schweitzer that relies on external donations and provides low cost, multidisciplinary tertiary health care for rural community of Artibonite Valley, and city of Dechapelles.

Methods:

The key methodology for data collection consisted of a literature, documents and project reports review alongside primary data collection such as group interviews with HAS ophthalmology service users (n=12) and facility observation. The review was supplemented by Practice Development Opinion Survey, with community health workers and nurses (n=57) engaged in case detection and referrals to the HAS ophthalmology department. Qualitative and quantitative data analysis utilized triangulation of multiple sources of data, synthesis of information, descriptive statistical analysis and contextual interpretation of findings.

Results:

Review revealed phenomenon of reversed medical tourism of low income, uninsured, diasporic population from Americas, about 15 patients per year, attracted by quality of outcomes, price and technical competence of eye surgeon. At 15% surgical facility’s utilization rate, the department provides, in average, 300 cataract surgeries per year. Representative community members expressed willingness to absorb cost of surgery through co-financing. In addition to steady income generated by surgery and consultations, the department works closely with communities, State University, Swiss health Alliance, and private businesses to diversify services, supply and build a sustainable local market for eye care services.

Conclusions:

The intermediate outcomes for this project include: increased population demand for cataract and glaucoma surgery; reversed medical tourism from Americas; increased supply by local pharmaceutical manufacturers and importers of affordable, high-quality eye drug and consumables; expanded distribution of glasses through in-hospital and private shops in Dechapelles and in hard-to-reach areas of Artibonite Valley; created national model of ophthalmology service that generates sustainable revenue in low socio-economic population, in the setting of externally financed hospital. Applying principles of marketing, enabled HAS ophthalmology medical team to compete successfully for the survival of the department and for benefit of the rural population.

Financial Disclosure:

NONE