Box 67.3Success Story: Cataract Surgery in India

Prevention strategies aimed at known risk factors, such as tobacco use and exposure to the sun, are unlikely to have a significant effect on the need for surgical treatment of cataracts in the foreseeable future (Ellwein and Kupfer 1995). The benefits of cataract surgery have been well documented in many developing countries.

In 1993–94, with a World Bank credit of US$118 million, India expanded cataract surgery coverage to the disadvantaged with the goal of reducing the prevalence of blindness. District blindness control societies were set up and given the flexibility of financing different providers of cataract surgery services to low-income groups at the district level (Rose 1997). Mobile camps were a strategy adopted for providing cheap and efficient cataract surgery in rural districts. Because of these efforts, cataract surgery nationally increased from 1.2 million surgeries in 1991–92 to 2.7 million in 1996–97. Singh, Garner, and Floyd (2000) analyze the cost-effectiveness of publicly funded options for delivering cataract surgery in Mysore, India, by assessing outcomes in a systematic sample of patients operated on in 1996–97. Patient satisfaction was 51 percent among those operated on in government mobile camps, 82 percent among those treated at the medical college hospital, and 85 percent among those treated in nongovernmental hospitals. Cost-effectiveness was US$97 per patient treated for the mobile camps, US$176 for the state medical college hospital, and US$54 for nongovernmental hospitals. Javitt (1993) estimates the cost of cataract surgery in India at less than US$25 per DALY averted.

As the World Health Organization (Brian and Taylor 2001) has stressed, successful and sustainable surgical treatment of cataracts is linked to a spectrum of other equally important activities, including ongoing training of surgeons, nurses, and administrators; reliable and affordable supply chains; and equipment purchase and maintenance.

Source: Authors.

From: Chapter 67, Surgery

Cover of Disease Control Priorities in Developing Countries
Disease Control Priorities in Developing Countries. 2nd edition.
Jamison DT, Breman JG, Measham AR, et al., editors.
Copyright © 2006, The International Bank for Reconstruction and Development/The World Bank Group.

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