A groundbreaking collaboration between the Clinton Health Access Initiative (CHAI) and EYElliance is shaping the future of the eye healthcare ecosystem in Uganda. The partnership is focused on increasing equitable access to vital assistive technology, specifically aiming to create routine, reliable access to eyeglasses for children, and eventually adults, across the country.
The origins and impact of this breakthrough partnership
In late 2022, EYElliance tapped into its global networks to generate a new opportunity that would pave the way for a national school-based eye health initiative implemented by the Ugandan Ministries of Health and Education.
We aligned efforts being made by the World Bank Uganda, UNESCO, and the Global Partnership for Education that led to a new allocation for school eye health as part of broader inclusive education funding in the Ugandan Ministry of Education’s multi-year budget.
Key in achieving this outcome was our burgeoning collaboration with CHAI Uganda which was formalized in a three-year MoU signed in January 2024.
In Uganda, CHAI and EYElliance's partnership efforts have borne fruit in a mere 15 months, demonstrating the power of strategic collaboration. With a modest budget of $200K, EYElliance and CHAI have orchestrated initiatives that create routine, reliable access to eyeglasses: laying the foundation for national school-based eye health led by the Ugandan government, initiatives to train community health workers to deliver reading glasses to those in remote and rural communities, and a ground-breaking public-private partnership to establish private optical shops co-located in public hospitals. This complements the work already being done by EYElliance to support local Ugandan optical entrepreneurs to grow their eyewear businesses.
Together, we’re also conducting a rapid assessment, at the Ministry of Education’s request, to update the magnitude of eye health conditions among school children - the results of which will inform the allocation of government resources. We are providing review and technical input on national policy documents, and we are exploring the potential to support the Ugandan government in establishing the new school eye program as part of inclusive education.
Collaboration through the lens of Isaac Okiring, Senior Coordinator Programs at CHAI Uganda
We recently sat down with Isaac Okiring, Senior Coordinator Programs at CHAI Uganda, to understand how this impactful partnership is functioning in practice. Along with his colleagues, Yewande Kamuntu, Senior Program Manager - Country Programs, CHAI Uganda and Joy Batusa, Country Director, CHAI Uganda, we explore the practical nature of EYElliance and CHAI model of collaboration in Uganda, emphasizing its value, and the mutually beneficial outcomes achieved through this transformative approach.
Tell us about the different roles EYElliance and CHAI play in the collaboration. How are EYElliance and CHAI working together in Uganda?
“CHAI is committed to saving lives and reducing the burden of disease, especially among children and women, in low-and middle-income countries, while strengthening the capabilities of governments and the private sector in those countries to create and sustain high-quality health systems that can succeed without our assistance. Over the last three years, we have moved further to ensure inclusiveness of the health system, leaving no one behind. The partnership with EYElliance continues to enable us to achieve our goals.” says Joy Batusa.
Isaac explains that the collaboration is based on mutual benefit: with EYElliance tapping into the CHAI team’s knowledge of the local context, networks and understanding of Ugandan culture and government system navigation, while contributing valuable technical assistance, global evidence and insights from programs in other countries to assist CHAI to help the government improve healthcare delivery.
“CHAI is the local partner in Uganda. We have a very good understanding of the local context and we've supported government to pilot new transformational innovations and eventually evidence-driven scale up. We have built trust as a result of this.” says Isaac. “On the other hand, EYElliance has been in the eye health space more compared to CHAI. They have done work in other countries, so they have more experience. They have lessons they've been able to pick from the other countries, so providing that extra technical assistance in our collaboration is what they do excellently. The EYElliance team goes the extra mile to be our thought partners.”
One of the key strengths of the EYElliance and CHAI collaboration lies in CHAI’s partnership with government agencies. “Our role is really to strengthen government and to support government to achieve what it wants to do.” says Okiring. He highlights that CHAI collaborates with key government ministries such as the Ministry of Health, Ministry of Education and Ministry of Gender, Labour and Social Development, and key agencies such as the National Medical Stores, National Drug Authority, and Uganda National Bureau of Standards. Isaac explains that the assistive technology (AT) program in Uganda, in particular, necessitated using a multi sectoral approach, “Because various Ministries do different pieces of work, and not all responsibility is typically held centrally.”
Isaac confirms, “Because of the partnership with EYElliance, the confidence and knowledge of the local context that we bring, and the experience from the EYElliance, we are able to do this work.”
How is this joint approach fostering government ownership and sustainability?
Isaac explains that the emphasis of CHAI’s work in Uganda is on promoting assistive technology and ensuring sustainability and government ownership in their initiatives. Their multi-sectoral approach brings different ministries together and aligns their efforts for more effective outcomes.
Isaac underscores the importance of government leadership and sustainability in the introduction and scale-up of vital eyeglasses programming in Uganda. “We frame project goals or objectives along what the government strategy and priorities are. Even in situations where we support the government to shape the framework or the strategic direction, it's a collaborative approach where they take the lead.” says Isaac.
Isaac recognises that EYElliance shares this approach and speaks to the benefits thereof. “Their approach translates to letting government take the lead. In our collaboration, we look at scalability, sustainability, and prioritize government ownership and leadership.”
What are the milestones you have unlocked through this partnership?
Isaac explains that the emphasis of the partnership in Uganda is on translating collaborative work into tangible impact, moving beyond individual partnerships for a more significant, lasting change in eye healthcare. "Every single piece of collaborative work we do, it's about how this is going to translate to impact. It's not about ticking it off to say we've done ABC."
The strong partnership between EYElliance, CHAI and the Ugandan government has facilitated effective advocacy and newly developed policies and plans in education and healthcare. The impact achieved includes foundational work on the national rehabilitation and assistive technology strategy and guidelines, operational plans for a national school eye health program, policy and funding influence, data-driven advocacy, collaboration between private and public sectors, and efforts to streamline the supply chain for eyeglasses.
Developing the National Vision Rehabilitation Guidelines and an AT Working Group
"Our first few years of work in Uganda has been about setting foundations. We've been able to particularly support government to develop the first-ever rehabilitation and assistive technology strategy as well as vision rehabilitation guidelines for the country, which handles all ages, services, right from vision, through hearing." says Isaac. “The Ministry was relying on us a lot for technical advice, shaping the guidelines, priorities, and interventions. EYElliance supported me with gathering the information and evidence that I needed, and I was able to translate this to the team at the ministry.” Isaac goes on to explain that "We've also been able to set up a multisectoral Assistive Technology (AT) Technical Working Group led by the Ministry to advise on provision of assistive technologies, including glasses.
Foundational achievements on prioritizing school eye health programming and funding influence
As stated before, EYElliance tapped into their global networks to generate a new opportunity that would pave the way for a national school-based eye health initiative implemented by the Ministries of Health and Education. By aligned efforts being made by the World Bank Uganda, UNESCO, and the Global Partnership for Education they unlocked a new allocation for school eye health in the Ministry of Education’s multi-year budget. This kickstarted their collaboration with CHAI Uganda.
Isaac acknowledges EYElliance's significant contribution to shaping Uganda's school eye health programming, stating, “EYElliance’s experience, particularly with Liberia, has helped us to think through and shape Uganda’s school eye health programming.” He emphasizes EYElliance's instrumental role in prioritizing school eye health within Uganda's complex landscape of competing issues, limited resources, and evidence base. Isaac credits EYElliance for advocating for the inclusion of school eye health in governmental decision-making processes, citing their assistance in building a compelling case supported by global evidence. Furthermore, he highlights their impact on securing funding for school eye health initiatives, including its inclusion in the pending Global Partnership for Education Grant. Isaac describes EYElliance's support in providing crucial talking points and briefs, enabling him to effectively advocate for school eye health at the ministry level. He emphasizes the collaborative effort between himself and EYElliance, resulting in government recognition of the importance of school eye health and the allocation of specific funding for its implementation .
Data Generation for Advocacy
Isaac goes on to explain that in the coming months CHAI and EYElliance have plans to gather more advocacy tools together. “Uganda as a country doesn't have prevalence data on visual impairment in school aged children. We'll be looking to conduct a school eye health rapid assessment (SEHRA), where we plan to assess children and generate data on magnitude of eye health conditions among public school students. This will be a great advocacy tool as we will be able to articulate the burden of unaddressed poor vision even better than before. Allowing us to negotiate with the Ministry of Education to increase the budget allocation for school eye health.”
Private-Public Sector Collaboration
“We realize Uganda’s private sector is much more advanced than the public sector.” explains Isaac, “So how do we get these two sectors together to see how we can provide the eye health services we are looking at?” He goes on to answer, “We are discussing a private-public partnership, supporting government to shape provisioning vision screening, glasses, and resource mobilization.”
Supply Chain Enhancement
“In Uganda, eyeglasses are not considered an essential health commodity and are subjected to tax like any other consumer goods.” states Isaac. “We are working to streamline the supply chain, making a case for reclassification as an essential health supply to waive taxation. Once it's an essential commodity, then we can talk to managers of the public supply chain to ensure glasses are integrated."
What does the EYElliance team bring to this collaboration?
“In the short time we've been working together. The expertise that EYElliance has in the eye health space, particularly at the global level, has played a significant role.” says Yewande Kamuntu, Senior Program Manager - Country Programs, CHAI Uganda. “I think the partnership has been very complimentary and has enabled us to achieve much more than either party could have achieved alone.”
Isaac recounts his experiences of working with the EYElliance team, outlining their transparent approach, collaborative feedback, appreciation for government ownership, and a focus on quality.
Transparency and Constructive Feedback
"Colleagues from EYElliance have been very transparent and open with us, giving me very constructive feedback. They look at it from a point of view of ‘how do we make it better, together’."
Appreciation of Government Leadership and Sustainability
"Both CHAI and EYElliance appreciate government leadership and sustainability. We are able to move with the government in sync. They've been patient to give us that time and make sure we are able to bring the government on board."
Emphasis on Quality of Care and System Strengthening Approach
"Both CHAI and EYElliance have an appreciation of the quality of care. It’s not just about getting glasses on people's eyes, but thinking through: does this person actually need a pair of glasses, which type of glass they need, what's the quality? We build using a system strengthening approach."
Isaac attributes the success of the partnership to the EYElliance team's willingness to provide constructive feedback and work collaboratively to find solutions.
Looking to the future
“As we envision the future, we see immense potential for further collaboration and partnership. With the continued support of EYElliance, we aim to explore innovative approaches, tackle new challenges, and pioneer solutions that can have a lasting impact on Eye health in Uganda.” says Joy Batusa, Country Director for CHAI Uganda.
CHAI and EYElliance’s collaboration is laying foundations for disability inclusion in Uganda's education and health system. Significant milestones have been achieved, and the focus going forward is now on generating prevalence data on visual impairment in school-aged children with the goal of advocating for increased government funding and fostering private-public partnerships.
"Our collaboration has created fertile ground for successful and sustainable introduction of scalable provision of quality eyeglasses." concludes Isaac. “We look forward to being able to pilot some of these interventions, generate evidence, and then be able to hand it over to government to scale it up. Government is very receptive now and excited. Especially knowing that they have thought partners to think through how this is run.”
The EYElliance and CHAI model of collaboration in Uganda stands as a testament to the transformative power of partnerships in shaping the future of eye healthcare. Isaac’s insights into the collaboration highlight the value and benefits derived from a mutually beneficial approach. As the collaboration continues to evolve, the focus remains on sustainability, government ownership, and the shared goal of improving access to eyeglasses for all in Uganda.
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