PROG2017-2021_outcome_At least 65.990 children with vision problems in Tanzania have access to qualitative eye care services in order to enroll the children with a visual impairment (VI) in primary education so that they achieve the functional basic skills, essential for future life.

The specific objective of the programme implemented in Tanzania reads as follows: “In Tanzania, at least 65,990 visually impaired children have access to quality eye care. Visually impaired children can attend elementary school and build skills that they will need for the rest of their lives.” The programme aims to contribute to ensuring that persons with disabilities, in this case a visual impairment, have equal opportunities in all areas of life. It is important to pave the way for equal opportunities during childhood. In elementary school, children learn how to write, count and read and are provided with the chance to gain general knowledge and to develop themselves as a person. It is the Itinerant Teachers’ (IT) responsibility to provide for these children’s specific learning needs allowing them to participate in the regular school curriculum. Those activities are referred to as “extracurricular activities” including skills such as orientation and mobility helping children to move safely, efficiently and effectively both within the school and between their home and the school; therapy for visually impaired children teaching them how to use low vision aids and training their residual vision; training their tactile senses; (pre-)braille. Children can only qualify for the ‘Itinerant Teaching Programme (ITP)’ after receiving every single form of medical eye care they might need, the diagnosis of blindness or visual impairment being only made after medical correction. Furthermore, in many cases, blindness can be prevented through early detection. A five months old baby, born with congenital cataract, will have perfect eyesight after cataract surgery. Refractive errors such as short or long sightedness can easily be corrected with glasses. Without correction, consequences can go as far as blindness. This is why the programme is especially focusing on prevention by means of awareness-raising campaigns and early detection. After a pre-screening, children with a visual acuity of less than 6/18 are referred to a district or regional hospital and, if need be, to a specialized tertiary eye unit. Not all district hospitals provide eye care. And there are quite a few challenges at regional level as well: shortage of skilled personnel, shortage of equipment and materials, etc. The programme supports two referral hospitals: training ophthalmic personnel, purchasing equipment. The children forming part of the programme are not the sole beneficiaries of the programme which will, in the end, yield profitable results in the whole community in the referral hospitals’ catchment area. Bringing eye care closer to the people not only lowers transportation costs and the time away from home and hence the loss of income, but it also lessens the lack of information and misbelief as far as eye diseases and possible treatments are concerned. During the four years of training in eye care the hospitals’ future ophthalmologists have to follow, a specialized hospital organizes outreaches in the regions concerned in order to provide eye care to the children and train the other categories of eye care staff. An ITP is also set up in both regions. Specialized hospitals as KCMC and CCBRT can only pass along their knowledge and skills if they are adequately staffed, if their personnel has been properly trained and has been kept abreast of the latest developments and techniques. This is why special attention is being paid to further professional development and ongoing training. Successfully implementing a programme can only be achieved with partners who perform very well in terms of organisation. The programme targets this objective through supporting stronger financial management and a (digital) monitoring and assessment system at one of the partners. Data collection in the field, spread over all constituent districts of the four regions, is a major challenge. A closer look will be taken at ‘mobile tracking’ systems. There is no doubt that, in the context of the ‘theory of change’, the Tanzanian government plays a key role in the programme. We will focus on lobbying and advocacy towards decision-makers, in order to boost the government’s commitment to inclusive education and to put the rights of children with a disability (visual impairment) higher on the political agenda. For the time being, the local partner TSB has concluded a cooperation agreement with the local government.