ecsat thumbnail image onlyIn 2022, researchers from the Community Eye Health team (Pushkar Silwal, Renata Watene, Jacqueline Ramke) were commissioned to prepare a detailed report that summarises the state of eye care services in Aotearoa New Zealand. The report highlights that while New Zealand has a solid foundation for good quality eye care services, there is room for improvement in the way we plan and deliver eye care services to ensure all New Zealanders can access the services they need.

Eye Care in Aotearoa New Zealand (2022) uses the World Health Organization’s Eye Care Situation Analysis Tool (ECSAT) to summarise the performance of our eye care services. The tool consists of 31 items (grouped into six ‘building blocks’) that each assess a different component of New Zealand’s eye care services.

Why did we undertake an ECSAT?

Globally, more than a billion people live with vision impairment and the negative effects this can have on their lives. To reduce this problem, in its inaugural World report on vision, the World Health Organization called for eye health to be part of efforts to achieve universal health coverage (UHC) through implementing Integrated People-centred Eye Care across the spectrum of promotive, preventative, curative and rehabilitative services. In 2020, this call was adopted by 194 countries at the 73rd World Health Assembly (including Aotearoa). To improve our eye care services, we must first understand the strengths and weaknesses of current services. This understanding is enabled by ECSAT, which is the first of four tools in the Guide for Action developed by WHO to support countries to strengthen integration of eye care into the health system.

The ECSAT report was commissioned by Eye Health Aotearoa to support New Zealand’s policy makers to develop integrated people-centred eye care, and ensure that all New Zealanders can access quality care.

How did we prepare the report?

To prepare the report, we established a Technical Working Group that included members with experience in optometry, ophthalmology, primary care/general practice, rehabilitation and Māori health. We used information gathered from published documents, which we augmented by interviewing with people with detailed knowledge of eye care services. The report can be downloaded from the Open Science Framework.

The report was launched by Eye Health Aotearoa at Parliament on 27 July 2023.

What are the major findings of the report?

The report identified that components of our eye care services in Aotearoa that are generally “strong” or only “need minor strengthening”, include:

  • Service delivery: The quality of eye care services.
  • Workforce & infrastructure: Ensuring that workers are trained and available to provide eye care services.

In contrast, the components of our eye care services that had aspects that “need major strengthening” include:

  • Leadership & governance: Planning, integrating and coordinating services, with appropriate policies in place.
  • Financing: How services are funded, including reducing out-of-pocket costs for population groups who are less able to afford services.
  • Access to services: Availability of the range of services throughout the country, as well as whether all population groups can access them.
  • Information: How service performance is monitored, and whether evidence is used to inform how services operate.

The report provides a detailed list of 81 recommended actions that may help strengthen eye care services in New Zealand.

The published report is available for download here.


ecsat coverThe report was prepared for Eye Health Aotearoa, with funding from Blind Low Vision New Zealand.

School of Optometry and Vision Science Authors: Pushkar Silwal, Renata Watene, A/Prof Jacqueline Ramke

Suggested citation: Silwal P, Watene R, Cowan C, Cunningham W, Harwood M, Korau J, Sue W, Wilson G, Ramke J. Eye care in Aotearoa New Zealand 2022: Eye care situation analysis tool (ECSAT). Auckland: University of Auckland, 2022.