Renata is renowned for her work in indigenous eye health in Aotearoa. Her presentation titled “Indigenous Voice from Aotearoa – A kōrero about what we can learn from one another.”was well received by the 240 delegates, including the more than 100 First Nations representatives from all corners of Australia.
The conference served as a valuable platform to promote equitable outcomes for Aboriginal and Torres Strait Islander communities. The conference theme, “Our Vision in Our Hands: Finding Our Voice,” emphasised the importance of emerging and future First Nations leaders while acknowledging our current leaders’ and esteemed Elders’ pivotal previous work.
During her presentation, Renata delved into the similarities and differences between Aboriginal & Torres Strait Islander and Māori cultures, explored the role of Te Tiriti, and highlighted the vital role health practitioners play in achieving equitable outcomes for Indigenous Peoples.
Overall, the National Aboriginal and Torres Strait Islander Eye Health Conference proved to be a momentous occasion, fostering collaboration and understanding among delegates, and paving the way for future progress in achieving equitable outcomes for all.
See here for a detailed summary of the National Aboriginal and Torres Strait Islander Eye Health Conference 2023.
Buchanan Charitable Foundation Postdoctoral Fellow Dr Pushkar Silwal (middle) pictured with team members A/Prof Jacqueline Ramke (left) and Dr Braden Te Ao (right).
Pushkar Silwal, a member of the School of Optometry and Vision Science’s Community Eye Health team and the inaugural Buchanan Charitable Foundation’s Postdoctoral Fellow hopes that our transforming health system will better support eye care services that are accessible to everyone.
Although 1.1 billion people experience impaired vision globally, eye health is often overlooked as a public health concern. The ongoing health sector reforms that began in mid-2022 provide a unique opportunity for Pushkar and his colleagues to build on previous research findings and generate much-needed evidence on how eye care services can be more accessible and equitable in New Zealand.
In February 2023, Pushkar began a three-year postdoctoral fellowship funded by the Buchanan Charitable Foundation—a home-grown, philanthropic foundation that supports community development. During his Fellowship, Pushkar will undertake a series of research projects that will investigate how to strengthen our health system, with the goal of improving eye care services in Aotearoa. He will also engage with academics, programme managers, and policy makers to identify opportunities to promote the inclusion of eye health in health system monitoring.
“We hope this will allow us to translate the knowledge we generate into practice,” says Pushkar.
This work will follow on from Pushkar’s PhD research, where he examined whether the measures we use to monitor our health system are appropriate. During his Fellowship, Pushkar will maintain an honorary appointment within the School of Population Health and will be mentored by A/Prof Jacqueline (Jacqui) Ramke from the School of Optometry and Vision Science (SOVS) and Dr Braden Te Ao from SOPH.
“We are very excited to have Pushkar commence his fellowship with us and welcome his commitment to generate evidence to support equity-focused decision-making in eye health. We are very fortunate for this ongoing support from The Buchanan Charitable Foundation and thank them for their commitment to improve eye health for all New Zealanders”, says Jacqui.
To advocate for improved eye care, Pushkar will draw on a growing body of evidence that New Zealand eye care services are lacking. Last year, he co-authored a report titled “Eye care in Aotearoa New Zealand 2022” that found a range of areas where our eye care services could be strengthened. Commissioned by Eye Health Aotearoa and funded by Blind Low Vision New Zealand, the report systematically assessed our eye care services using an analysis tool developed by the World Health Organization. Importantly, the report provided a list of 81 recommended actions for policy makers to improve our eye care services.
“Our report shows that access to eye care services needs major strengthening,” he says.
Pushkar has a long-standing interest in health systems research. He completed his Master of Public Health in 2016 at The University of Auckland under the Manaaki New Zealand Scholarships Programme and has actively contributed to teaching public policy and health systems at The University of Auckland. This will continue during his fellowship when Pushkar, alongside Jacqui, will integrate a new public health teaching module within The University of Auckland’s Bachelor of Optometry programme. He hopes that this will help build eye health in Aotearoa from the ground up, so that future optometrists can advocate for and deliver accessible eye health services for everyone.
A collaboration between the Fred Hollows Foundation and The University of Auckland’s Centre for Pacific and Global Health and School of Optometry and Vision Science aims to assess the state of eye health in the Pacific using locally-driven research.
In July 2021, the Community Eye Health team conducted a pilot eye health survey in the Glen Innes, Panmure and Ōrākei areas of Auckland. This survey gave us the opportunity to collect information about the state of eye health in a small group of New Zealanders, before we embark on our more ambitious population-based eye health survey in 2023.
Lead Optometrist and PhD candidate Jaymie Rodgers played a key role in the day-to-day operations of this pilot study.
“As part of my research project, I am delivering comprehensive eye examinations to people in this community where we believe there may be unmet eye health needs. In particular, we want to know if there are any differences in access to eye care,” says Jaymie.
Throughout the pilot study, Jaymie together with Optometrist and Professional Teaching Fellow Veeran Morar supervised a team of clinical optometry students as they conducted eye examinations at the Te Whare Piringa community centre in Glen Innes.
Watch Jaymie and team set up the eye clinic at Te Whare Piringa community centre in Glen Innes, above.
Currently, Jaymie is busy analysing data from the survey pilot, and enrolling a cohort of participants for further follow-up. Her PhD research will continue within the population-based eye care survey that will begin in 2023, where she will will follow a group of participants with vision impairment over a 12-month period to understand the barriers that they face in accessing follow-up eye care services.
See inside the pop-up eye clinic, below:
Jaymie speaks with a survey participant who is picking up her new glasses
Jaymie examines a survey participant at the pop-up clinic
A student optometrist with two survey participants, who are picking up their new glasses
As part of the survey, we offer a full eye examination to all people identified with distance or near vision impairment.
The research team:
Jaymie and Veeran with BOptom students
L to R: Joanna Black, Jaymie Rogers, Jacqui Ramke and Matire Harwood
Funding:
The research team would like to acknowledge Peter and Rae Fehl, Blind Low Vision New Zealand and New Zealand Association of Optometrists for their support.
Participants in this project are benefiting from the SOVS Community Spectacle Scheme, which is supported by Helen Blake, Barbara Blake and Essilor.
The report, which draws on research co-authored by SOVS Associate Professor Jacqui Ramke, will serve as a reference point for countries’ efforts towards meeting the ambitious global eye health targets endorsed by Member States of the 74th World Health Assembly in 2021. These are:
A 30-percentage point increase in effective cataract surgical coverage (eCSC) and
A 40-percentage point increase in effective refractive error coverage (eREC)
What is eCSC and eREC?
Effective cataract surgical coverage (eCSC) measures the number of people in a population that have been operated for cataract, and had a good outcome, as a proportion of all the people requiring or having received surgery in that population.
Similarly, effective refractive error coverage (eREC) is defined as the proportion of people in need of services to correct refractive error such as spectacles or contact lenses, who have received these interventions and have a resultant good-quality outcome.
You can read more about the importance of these targets and how they came to be adopted by the World Health Assembly — with a view to also making them proxy indicators for Universal Health Coverage — in a blogpost on the International Centre for Eye Health‘s website, written by Jacqui with London School of Hygiene and Tropical Medicine colleagues Professor Matthew Burton and Ian McCormick.
Here in Aotearoa, we continue to collect information on how people are experiencing eye health services, whether they are able to access the services they need, and what solutions might be needed to ensure that everyone who needs eye care in Aotearoa can receive it.
We are excited to soon begin a project that will include Aotearoa’s first population-based survey that will generate our first estimates of eCSC and eREC. These estimates are crucial to inform equity-focused planning, and will also help raise the profile of eye health on global health and development agenda.
World Sight Day is an International Day of Awareness, held annually on the second Thursday of October. This year, World Sight Day is Thursday, 13 October 2022. World Sight Day is coordinated by the International Agency for the Prevention of Blindness (IAPB).
This year, the IAPB, its members and partners is encouraging everyone to take a moment to think about the importance of eye health for everyone, everywhere:
Using data from population-based eye health surveys around the World, investigators (including School Of Optometry and Vision Science Associate Professor Jacqui Ramke) have published baseline estimates for effective Cataract Surgical Coverage (eCSC) and effective Refractive Error Coverage (eREC) .
What is eCSC and eREC?
Effective cataract surgical coverage (eCSC) measures the number of people in a population that have been operated for cataract, and had a good outcome, as a proportion of all the people requiring or having received surgery in that population.
Similarly, effective refractive error coverage (eREC) is defined as the proportion of people in need of services for poor eyesightrefractive error such as spectacles or contact lenses who have received these interventions and have a resultant good-quality outcome.
Cataract surgery and correction of refractive error remain two of the most cost-effective healthcare interventions ever. These two indicators serve as ideal proxy indicators not only to track changes in the uptake and quality of eye care services at the global level, but also contribute to monitoring progress towards UHC in general. In 2021, the World Health Assembly set ambitious global eyecare targets for 2030 of a 30% increase in eCSC and a 40% increase in eREC.
The paper on Effective Cataract Surgical Coverage shows the indicator varies widely between countries, with higher coverage in countries with greater income-level, with the highest at 70.3% and the lowest only 3.8%. Higher coverage was also seen among men, highlighting the need to embed equity in efforts to improve access to surgery.
The paper on Effective Refractive Error Coverage estimated that less than half (43%) of people who need glasses for distance vision have had this need met. The paper’s authors note that despite coverage increasing by 19% in the last 20 years, the WHO target will require substantial improvements in quantity and quality of refractive services, particularly for women and among older people.
Speaking on behalf of the WHO at the launch of the “Report of the 2030 targets on effective coverage of eye care”, at the United Nations in New York on 12 October, the eve of World Sight Day, Dr Stuart Keel said: “These two papers set the baseline for what we want to achieve by 2030 and the international collaborative effort demonstrates how well-positioned the eye care sector is to contribute to the advancement of Universal Health Coverage within countries”.
The work for the eCSC study was funded by the Indigo Trust, Peek Vision, and the Wellcome Trust, while the eREC study was funded by WHO, Sightsavers, The Fred Hollows Foundation, Fondation Thea, Brien Holden Vision Institute and Lions Clubs International Foundation.
In May 2023, Renata Watene was honoured as the first International Keynote Speaker at the prestigious National Aboriginal and Torres Strait Islander Eye Health Conference in Parramatta, Australia.
A collaboration between the Fred Hollows Foundation and The University of Auckland’s Centre for Pacific and Global Health and School of Optometry and Vision Science aims to assess the state of eye health in the Pacific using locally-driven research.
