A pioneering eye health project in Malawi has broken barriers to health equity by bringing health services to community level. The project, supported by international development organisation Sightsavers, reached over 122,000 people, including women and people with disabilities, across rural and high-poverty areas in the South West Health Zone.
Globally, women account for more than half of blindness and visual impairment1, and compared to people without disabilities, people with disabilities are also three times less likely to get the healthcare they need2.
In Malawi, an estimated 1.7 million people had vision loss in 20203. Everyone, including remote communities, women, people with disabilities, should have access to health services, but availability and awareness varies across the country.
The project came at a time when the government is working towards achieving the United Nations Sustainable Development Goals, including ‘universal health coverage’ which means ensuring everyone has access to health services.
Effie Kaminyoghe, Senior Programme Manager at Sightsavers comments: “Unless inclusive eye health is recognised as a vital part of community healthcare, and inclusion of people with disabilities, women, and other marginalised groups is improved, efforts to achieve universal health coverage in the country will fail.
“The big achievement of this project was bringing eye health services down to a community level and ensuring more people could access and afford the services they need without traveling long distances or incurring debts. We also provided input to the National Community Health Framework, to ensure it was inclusive of persons with disabilities. The framework, which sets out community health intervention guidelines, was launched by the State president in November 2023, and demonstrates government’s commitment to community and national health.”
The project was funded by the UK government and the British public through UK Aid Match. In partnership with the government and other partners, Sightsavers supported activities including eye health screenings, surgery, hospital transport, health facility accessibility audits.
It created systemic change through gender and disability inclusion training for health staff, supporting training of community-based ophthalmic clinical officers, and eye health awareness activities. This includes volunteer eye health ambassadors who share their own stories of treatment to encourage others to access services.
The story of Esther demonstrates the importance of community health care. Vision impairment meant she could not continue her fish-selling business or care for her children. Her life became “troubled”, and she felt she “did not belong to this world”. Through the eye health project, Esther was diagnosed with cataracts and referred for surgery.
After surgery, she hugged her children, realising this was the first time she had seen some of them. She now takes care of her children and supports her husband with piece work. For her children, particularly her eldest who missed school to support her, she says: “It has changed a lot. They go to play. They go to school. They know that when they come back…they will find food prepared.”