Identifying Landmark Achievements in Primary Eye Care Promotion in Nigeria in Accordance with Alma – Ata Declaration of 1978: A Review

Background: Alma Ata declaration form the bed rock that link primary health care (PHC) and health promotion to enable individuals and communities to increase control over the determinants of health. The declaration is meant to address the main health problems in the community by providing promotive, preventive, curative and rehabilitative services including visual impairment.

Objective: To evaluate the landmark achievement of eye health promotion for prevention of visual impairment in Nigeria.

Methods: A non-systematic review of published literatures was adopted to develop this narrative review. Literatures searches were done through PubMed, google scholar and biomed central. Search terms included primary eye care (PEC), health promotion and Nigeria. 45 articles were reviewed.

Results: Landmark achievement includes elimination of blinding trachoma and onchocerciasis as a public health problem following the treatment of 120 million people. Evaluation of the collaboration between Sightsavers, UK and the Ministry of Health in Sokoto State (Northern Nigeria) on VISION 2020 – Right to Sight program; showed an increase in the proportion of persons aged 50 years and over without visual impairment from 54.7% in 2005 to 77.3% in 2016. The prevalence of blindness in same age range declined from an estimated 11.6% to 6.8%, severe VI from 14.2% to 4.3% and moderate VI from 19.5% to 11.4%. A reduction in the estimated all‑age blindness prevalence by more than a half from 2.0% in 2005 to approximately 0.75% in 2016 was reported. No known similar evaluation was surveyed in the southern part of Nigeria to the knowledge of the researchers. However, non-integration of eye health promotional policy into PHC have left the Nigerian population in the miry clay of sustained prevalence of avoidable visual impairment.

Conclusion: Alma Ata Declaration called on all governments to formulate national policies, strategies and plans of action to launch and sustain primary healthcare, integration of PEC and eye health promotional policies into PHC system to reduce the public health burden of avoidable visual impairment.