Assessment of Eye Health Services: A Health Systems Approach

  • Haroon AwanEmail author
Part of the Essentials in Ophthalmology book series (ESSENTIALS)


This chapter aims to introduce the reader to how a health systems approach can be used to assess eye health services for planning and development in the context of a broader system. A health system assessment can be carried out at various levels of health care.

In order to facilitate collection of information on the provision of and access to eye health services, and the development of evidence-based interventions for their further improvement, WHO developed the ‘Eye Care Service Assessment Tool’ (ECSAT). ECSAT is also intended to assist implementation of the selected evidence-based interventions, as periodic completion of the questionnaire can provide data and information for assessing the impact of interventions and identify trends and newly emerging needs.

Other tools that one can use include:
  • Tool for the Assessment of Diabetic Retinopathy and Diabetes Management Systems (TADDS)

  • Tool for Assessment of Rehabilitation Support Services (TARSS)

  • Rapid Assessment of Avoidable Blindness (RAAB)

Not all the information for completing a thorough assessment of eye health service may be readily available. Some may require more efforts to obtain and some may not be available at all, for instance, epidemiological data on the magnitude and causes of vision impairment or national data on selected treatment procedures such as cataract surgeries.


Blindness Cataract Diabetic retinopathy Eye health Health services Health systems Low vision Ophthalmologists Visual acuity Visual impairment 


Compliance with Ethical Requirements

Haroon Awan declares no conflict of interest.No human or animal studies were carried out by the authors for this chapter.Acknowledgments:I am most grateful to Dr. Ivo Kocur, Medical Officer, Blindness and Deafness Prevention, Disability and Rehabilitation, World Health Organization, for his insightful suggestions and technical guidance in preparation of this chapter.


  1. 1.
    Chen GKC. What is the systems approach? Interfaces. 1975;6(1, Part 1 of Two):32–7.CrossRefGoogle Scholar
  2. 2.
    Everybody’s Business–Strengthening Health Systems to Improve Health Outcomes. WHO’s framework for action. World Health. Organization; 2007.
  3. 3.
    Resolution WHA58.33. Sustainable health financing, universal coverage and social health insurance. In: Fifty-Eighth world health assembly, Geneva, 16–25 May 2005. Volume 1. Resolutions, decisions, Annexes. (WHA58/2005/REC/1). Geneva: World Health Organization; 2005.Google Scholar
  4. 4.
  5. 5.
    Eye Care Service Assessment Tool (ECSAT). World Health Organization; 2016.
  6. 6.
  7. 7.
    Tool for the Assessment of Diabetic Retinopathy and Diabetes Management Systems (TADDS). World Health Organization; 2015.
  8. 8.
    Global Data on Visual Impairments 2010. World Health Organization; 2012.
  9. 9.
    Tool for Assessment of Rehabilitation Services. World Health Organization; 2015.Google Scholar
  10. 10.
    Marmamula S, Keeffe JE, Rao GN. Rapid assessment methods in eye health: an overview. Indian J Ophthalmol. 2012;60(5):416–22. Scholar
  11. 11.
    RAAB Repository.
  12. 12.
  13. 13.
    What is universal health coverage? Geneva: World Health Organization; 2012.
  14. 14.
    The World Health report 2013: research for universal health coverage. Geneva: World Health Organization; 2013.
  15. 15.
    Monitoring progress towards universal health coverage at country and global levels: framework, measures and targets. Joint WHO/World Bank Group paper. 2014.
  16. 16.
    Tracking universal health coverage: first global monitoring report. Joint WHO/World Bank Group Report. 2015.
  17. 17.
    Gray Z, Ackland P. Cataract surgical coverage. An important indicator for eye health and for monitoring progress towards universal health coverage. International Agency for the Prevention of Blindness; 2015.
  18. 18.
    District Health Information System 2.
  19. 19.
    IAPB Vison Atlas.
  20. 20.
    Bourne RRA, Stevens GA, et al. Causes of vision loss worldwide, 1990–2010: a systematic analysis. Lancet Glob Health. 2013;1:e339–49. Scholar
  21. 21.
  22. 22.

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Avicenna Consulting Pvt LtdIslamabadPakistan

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