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Purpose: Development projects in eye health have evolved over the past fifteen years in response to VISION 2020: The Right to Sight. Estimates that 285 million people, mainly in the developing world, are needlessly vision impaired largely due to the lack of trained eye health professionals have moved development initiatives away from vertical, service delivery approaches towards the establishment of more sustainable, locally owned professional training programmes in an effort to ensure long term production of adequately trained human resource capacity to address this challenge. The Mozambique Eyecare Project was one such initiative, established as a solution to the challenge of uncorrected refractive error in Mozambique. It represented a unique multi-partner development project, proposing a regional, multiple entry and exit model of training in optometry catering to Lusophone Africa’s human resources for optometry need in the longer term. Given the uniqueness of the project and its proposed developmental solution, as well as the absence of documented benchmarks for development projects and partnerships of this nature, this research was undertaken to understand the MEP’s challenges, and use its experiences to inform future practices in this regard. Through this evaluative approach, the research aimed to define a systems framework for optometry development projects.
Methods: The study employed a qualitative, exploratory research design, chosen because qualitative research is not about measurement, but about understanding phenomena of interest. With critical reflection on the MEP, this study aimed to gain insight into, and identify the lessons from the MEP’s experience in order to contribute to enhanced effectiveness of development interventions in optometry and eye health. Data collection was by means of key informant interviews, using purposive sampling. Eighteen informants were interviewed based on their individual roles in the project. An interview guide was used to pursue key lines of inquiry with each participant, relevant to the areas of interest in the research. Themes emerging from the data were analysed by inductive-interpretive reasoning and where possible, was validated by means of document analysis.
Results: Research funding may act as an opportunistic driver for novel development strategies, and a catalyst for mutually beneficial project partnerships. However, one of the key drawbacks may be a mismatch between the funding cycle and the project cycle. With strong leadership and communication, shortcomings around funded support can be addressed in order to achieve a project’s objectives. Planning processes and sustainability considerations are critically important to project efficiency. In addition, situational and stakeholder analyses must be conducted, with local partners having equal input into the design and construct of training models and programme structures. Partners would do well to avoid a hierarchical structure to the partnership and project management activities, being conscious of the need to drive a participatory approach in all its endeavours. Roles and responsibilities must be clearly articulated and language needs planned for upfront, where applicable.
Conclusion: Sustainability considerations must be factored into the planning phase of projects of this nature, so that the development investment presents long term value for beneficiaries, partners and funders. By adopting a systems approach to the design, planning and implementation of development projects in optometry, stakeholders will be guided towards increased efficiency in project output, cost containment and constructive partner relations.
Wallace, D. (2016) A systems framework for development projects and partnerships in eye health training. Doctoral thesis, Technological University Dublin, 2016. doi:10.21427/D71W40