BY ALLISON GRANDE, HANNAH KYLE, EMILY SCHAUB, and PABLO VILLAR VILEIKIS
Allison Grande, Hannah Kyle, Emily Schaub, and Pablo Villar Vileikis are second-year International Development students who recently traveled to Telangana, India, to develop data-driven communications materials on the benefits of eye care for L.V. Prasad Eye Institute (LVPEI) as part of the IDEV Practicum.
The IDEV Practicum allows students to work directly with public, private and non-governmental organizations as a capstone to their graduate studies. The IDEV Practicum Blog is a six-part series that chronicles the travels of IDEV students who take on client projects over winter break.
We arrived in Hyderabad in the uncharacteristic repose of a kite festival – the night sky was full of kites, and the highway, normally a life-or-death Tetris game, was calm and quiet. As we walked into LV Prasad’s Centre of Excellence, a hospital in the middle of the city, we noticed that it was empty, save a couple of staff working late and ophthalmology fellows feverishly studying patient data. However, the next morning, we awoke to waiting rooms full of patients there for sight-saving eye surgery and the buzz of a well-run hospital. As a team of four, we were there to study the benefits of eye care for LV Prasad’s rural patients.
L.V. Prasad Eye Institute (LVPEI) is a study in making decentralization work. It operates 169 primary care centres in Telangana, Andhra Pradesh, Odisha, and Karnataka; 17 secondary centres, three tertiary centres, and one Centre of Excellence. Caregivers track patients through the system, refer them to higher levels of care, and distribute glasses in rural areas. In 2015-2016, they reached 2,552,444 patients, of which 1,116,090 were eye exams given at no cost to the patient. They do all of this with a payment model that gives everyone, regardless of income, access to eye screenings and surgery when necessary. Spectacles start at 80 rupees/frame each (currently, 65 rupees is $1). LVPEI trains Vision Technicians from rural communities to staff each primary care centre, and doctors flock from all over the world to study and work with LVPEI staff in this model.
Though LVPEI’s impact is obvious and its methods innovative, the primary centres vary in cost of operations and number of patients seen. This led to our question: “How can we quantify the benefit of LVPEI’s services given the investment needed to reach otherwise unserved populations?” Using a survey we created, we ventured into rural Telangana with an LVPEI team to ask patients how they had benefited from the treatment they had received. Through our conversations with patients and staff, we identified five indicators, which can be used in the future to quantify changes in quality of life in LVPEI’s patient population: mobility, productivity, mental wellness, daily activities, and security.
During our stay in rural Telangana and in Hyderabad, we heard many valuable stories that will form the basis of external communications we develop for LVPEI. We heard from patients who, post-treatment, were able to sign their own names on financial documents. We heard from a mobile telephone retailer that, with glasses, has been able to diversify his business and repair cell phones. We heard many times of people feeling safer in their surroundings because they were able to identify the faces of those known to them. Others told us that they felt safer going out to use the toilet at night.
Through this experience, we have connected the economics we study at SAIS to people. We also experienced first hand the importance of connecting with people through fieldwork in international development. Ultimately, these are things that we will take forward in our careers, both domestically and abroad.
By quantifying the benefit LVPEI brings to its patients through two cost effectiveness ratios – rupees per perceived change in quality of life and rupees per standardized utility score for eye care in India – and embedding those numbers into the narratives shared with us during our two weeks in India, we will be able to contextualize the impressive impact LVPEI has and its progress toward its mission: to provide equitable and efficient eye care to all.