title: Improving access to eye health services in rural Timor-Leste.
abstract: BACKGROUND
  Delivering eye health services to people in rural areas, especially in fragile, post-conflict countries, is a major challenge. This article reports on the implementation and evaluation of an innovative district-based outreach service. The main project partners were the Timor-Leste Ministry of Health and an international non-government organization, with assistance from a local non-government organization.
  
  
  OBJECTIVE
  An eye care nurse in Covalima District, a remote location 178 km from Timor-Leste's capital, Dili, was provided with a motor-bike for transport and regular support for outreach eye services to sub-district facilities. Data collected over the first year of operation were examined and included: services provided, spectacles dispensed, health promotion activities conducted and the cost of providing these. The project was also evaluated for its relevance, effectiveness, efficiency, impact and sustainability.
  
  
  CONCLUSIONS
  In the first 12 months, 55 outreach visits were conducted across the district's seven sub-districts during which 1405 people received vision screening, and 777 spectacles were dispensed. In addition to meeting the five evaluation criteria, compared with the hospital-based eye clinic the outreach service resulted in significantly greater gender equity among eye health service beneficiaries. This pilot project demonstrates what can be achieved when a Ministry of Health (central and district level) and non-government organizations (international and local) work in partnership to support a dedicated health care provider.
authors.affiliation: The Fred Hollows Foundation New Zealand, Auckland, New Zealand.
authors.forename: Sara M
authors.initials: SM
authors.lastname: Pereira
authors.forename: Ilse
authors.initials: I
authors.lastname: Blignault
authors.forename: Renee
authors.initials: R
authors.lastname: du Toit
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Ramke
mesh_terms: D000328:Adult; D002648:Child; D002662:Child Health Services; D003376:Counseling; D003906:Developing Countries; D005128:Eye Diseases / Q000175:diagnosis / Q000517:prevention & control / Q000628:therapy*; D006293:Health Promotion / Q000191:economics / Q000379:methods*; D006297:Health Services Accessibility / Q000592:standards*; D006767:Hospitals, District / Q000458:organization & administration / Q000592:standards; D006801:Humans; D007318:Inservice Training / Q000191:economics; D007391:International Cooperation; D008505:Medical Staff, Hospital / Q000193:education; D010043:Outcome and Process Assessment, Health Care; D015397:Program Evaluation; D055818:Public-Private Sector Partnerships / Q000191:economics; D011785:Quality Assurance, Health Care; D019035:Rural Health Services / Q000191:economics / Q000458:organization & administration / Q000592:standards*; D012959:Socioeconomic Factors; D049648:Timor-Leste; D014186:Transportation / Q000379:methods / Q000592:standards; D015351:Vision Screening / Q000191:economics / Q000379:methods / Q000592:standards