ARAVIND EYE CARE SYSTEMS:

PROVIDING TOTAL EYE CARE TO

THE RURAL POPULATION
By Group 6
Abhishek Kumar-PGP/21/126
Akriti Prasad- PGP/21/131
Gaurav Shroff- PGP/21/145
Praveen Nirapure- PGP/21/166
Priyanka Prasad- PGP/21/168
 Indian Eye Care Market

Causes
Main cause of blindness- cataract
(50-60%) and diabetes.

Reasons for not turning up

GOI Initiative • Afraid of surgeries.
1976 NPCB was launched by GOI-
• Cost of transportation.
aimed at reducing the blindness
• Lost Wages.
from 1.4% to 0.3%.
• Food and Acomodation.

Key Predictors
Stat Gender and distance was found to
For every 100,000 there is one be main predictors. Men twice likely.
eye doctor in India. 3km or less distance more likely to
visit these services.

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 Operations – Aravind Advantage

Large volume resulted in low total costs.

Team of paramedics- dedicated, efficient, performed many
of the routine tasks of the doctors.

Economies of scale
Surgeons were 6 times more efficient than
competitors.
Improved efficiency
Resource planning was efficient to ensure no
shortages, no postponement of supplies or surgeons,
Resource Planning staff deployment and patient scheduling.

Technology Reduced through put time through communication

technology. ( information available through
computers to the right personnel swiftly.)
In-house production
AuroLab was established, producing IOL
and sutures at 10% and 25% cheaper rates
respectively.

3
 Aravind Eye Care
• Started by Dr. GV in Madurai City in the south Indian state of Tamil
Nadu.
• Vision – To provide quality eye care services at prices that everyone
can afford. To be achieved through high quality and high volume
approach.
• Improved their service mix and expanded it from cataract operations
to Multi speciality health care.
Pricing
Category Paying Non-Paying

Consultation 50 0

Cataract Surgery 4100-6000 750

Phaco Surgery 6500-41000 ---

Spectacles were also available from the hospital at cheaper prices. The
grinding was done in hospital while patient waited to save another trip
to them.
Service Delivery Options
Base Hospitals
• 5 tertiary and 2 secondary hospital.
• 60% people visiting the hospitals lived
nearby.
• Each hospital was also a teaching institute.
• Nearly 67% of the cataract patients received
free eye care. 39% of them were from camps.
• There were 73389 free surgeries performed
in 2010-11.
Community Centre Clinic
• Established to reach outlying areas with a
population of 1 lakh – 2 lakh.
• Within 50km of the base hospital. INR 30 as
consultation fee.
• Staffed by 1 ophthalmologist and 1 support
staff.
• Setup cost was between 8-10 lakhs. 40% of
the patients referred from the community
centre paid for the services.
Service Delivery Options
Vision Centres
• Established in locations with population of
50000 within 5km radius and 100000 within a
10km radius.
• Consultation charge was INR 20. Economic
advantage of INR 230 wrt other hospitals.
• Tele ophthalmologist consulted patients
through video conferencing.
• Nearly 10% were sent to base hospital other
90% treated at the centre itself.
• Cost of construction 8-10 lakhs. Recovered
within 2 years of operation.
Eye Screening Camps
• 2148 camps and 455378 patients , 76056 surgeries ,
77618 pair of eyeglasses distributed in 2009/10.
• Purpose- for generating demand, mobilizing the
community resources and image building.
• 4-5 camps per district per month were organised.
• Sponsors responsibility was to identify correct
locations, arranging building and water and other
support facilities.
• The challenges included community participation and
retention of community partners.
• Maintaining the quality was a challenge, only 6.8%
people attended the camps in a survey done on 48
villages.
Service Delivery Options

Mobile Unit and Refraction Van

• Funded by World Diabetes Foundation.

• Equipped to take a digital image to help detect diabetic retionopathy.
• Daily running cost 4-5k.
• 75 patients a day.
• Patients requiring primary treatment were sent to the nearest vision
centres.
Problem Identification- Lack of Rural Penetration
Despite the outreach program less than 10% of the population who needed eye care turned up for the camp

Steps to Improve Rural Penetration:

Step I Step II Step III

Improving Accessibility Raising Awareness Improving Acceptance

Improving Accessibility

Secondary Care Community District Wise Potential Total diff Potential to Probable
Districts City Center Vision Center Total No.
Hospital Clinic Potential Captured @30% increase Solution

1 1 2 8 119255 400000 30% 120000 745

Madurai
1 8 10703 40000 27% 12000 1297 VC
Theni
1 5 41109 250000 16% 75000 33891 CC+3VC
Tirunelveli
1 5 74134 250000 30% 75000 866
Coimbatore
5 40766 250000 16% 75000 34234 CC+3VC
Puducherry

Marginal
Patient Visit 56174 -11953 23149 3592
 Health Education Approaches
House to House visits by Campaign and video
House to House visits by ex-patients Screening camps
Health workers displays in vans

Language Y Y Y Y

Pictorial Presentation N Y Y Y

Utilitarian Y Y Y Y
Forms
Narrative Y N N Y

Trustworthy Y N N N

Source Likeable - - - -

Expert N Y N N

Association Y Y N Y

Surgical Acceptance Surgical Awareness

Raising Awareness
Recommendations

• Organizing “Nukkad Nataks” in villages and “haats “

• Ads ,narratives and talk shows of patients who have undergone surgery in local radio
• Starting a Toll free number or consultancy
• Training mid-wives to detect eye problems in kids and recommend them for follow up with
Aravind Eye Care
Improving Acceptance
Key Challenges
• Fear of Eye Damage during surgery
• Cost, both direct and indirect
• Treatment not considered worthwhile in old age
• Belief of interfering with God’s will
• Attitude of being able to cope up
• Lack of priority for eye care
Recommendations
• Campaigns by field workers in periodic markets
should include narratives from patients which
successful eye surgery
• Tie-up with Gram Panchayats and self-help group
to recommend eye checkups
THANK YOU!

QUESTIONS…