TO ELIMINATE NEEDLESS BLINDNESS

Agnivesh(302)|Shiba Majhi (343) |Rahul Tirmale (353)

Sivasubramanian(106)|Vinoth (357)
Group 7 | Rural Marketing

INTRODUCTION
Aravind Hospital was founded byDr. Govindappa Venkataswamy (popularly
known as Dr.V) started its operations in 1976 as an 11-bed hospital in
Madurai.
Worlds largest provider of eye care service each day handled an average of
6000 out patients, performs 850-1000 surgeries
A core principle of the Aravind eye care system was to provide services to the
rich and poor alike
ARAVIND EYE
CARE
SYSTEM

HOSPITAL
SERVICES

AURO LAB

EDUCATION
AND
TRAINING

EYE BANK

COMMUNITY
OUTREACH
PROGRAMS

RESEARCH
FOUNDATION

LAICO

SERVICES OFFERED
Comprehensive
Screening Eye
Camps

Retina &
Vitreous
Childrens
Eye Care

Diabetic
retinopathy
screening camps

Workplace-based
screening eye
camps

Cataract

Orbit,Oculo
plasty &
Ocular
Oncology

Neuro
Ophthalmol
ogy

SPECIALI
TY
CLINICS

Low Vision &

Visual
Rehabilitatio
n

Glaucoma

Uvea

Cornea

School children
screening eye
camps

Paediatric screening
eye camps

PRICING EYE CARE SERVICES

Consulting fee Rs.50 valid for 3 months
Cataract surgery Rs.4100 6000
Phaco surgery Rs.6500 40000 (depending on type of lens and the scale of
comfort
Patients were required to pay Rs.750 to cover the cost of the lens (who couldnt
afford even this amount all charges were waived of by the doctor in charge of the
out patients department)

ARAVINDS APPROACH
The staff alternated between working with the paying segment and free segment
every month
Provide free eye care to two-thirds of its patients by using revenues generated
from the one-third of the patients

Aravind Eye Care operations

High Productivity : Almost 6 times
Opthalmologist at Aravind eye care performed 6-8 surgeries per hour

Refined Procedures
Developed and perfected own version of manual sutureless surgeries
Each surgeon worked on two operation tables alternatively

Managing Time
Trained paramedic staff performed premilinary tests,scans instead of doctors performing it
Councellors provided information on costs and treatments
150 councellors on staff and 6 nurses for every doctor

Planning
Done on an yearly, monthly and daily basis to ensure resource availability

Use of Technology
Patient registration through computers
Generation of medical records of patients

Aurolab
Established to provide affordable eye care in developing countries
IOLs were priced to less than 10% of imported lenses
Manufactured sutures at 25% price of Imported sutures

Eye care Service in India

1 doctor for every 100,000 people
NPCB launched to reduce blindness from 1.4 to .3 %
Prevalence of moderate visual impairment was 8.09%
Of it 40 % was caused due to cataracts
Likely to be present in higher age groups, females, lower socio economic groups and rural population
By 2020 139 million would likely have moderate visual impairment

Cataract surgeries per million

12000
10000
8000
6000
4000
2000
0

Blind Persons(in Millions)

40
30
20
10
Gujarat

TN

National Avg

2000

2010

2020

Service Delivery Options

Base Hospitals
Base Hospitals
5 tertiary hospitals
5 tertiary hospitals
Functioned
like a regular ophthalmology
hospital
Functioned like a regular ophthalmology
hospital
60%
of patients visiting hospital lives nearby

60%
of patients
visiting institute
hospital lives nearby
It also acts
as a teaching
It also
acts as apatients
teaching
instituteservices
67%
of cataract
received
free
67%
cataract patients received services
of of
cost
free of
cost
Surge
witnessed
in cataract surgeries during
the
Surge
witnessed
period 2008-11in cataract surgeries during
period
2008-11
Inthe
newer
base
hospitals, greater ratio of
patients
In newer
base hospitals,
greater ratio of
availed
cost free services
patients availed cost free services

Service Delivery Options

Community Centre Clinics
Community Centre Clinics

Vision Centres
Vision Centres

Located around city centre clinic to reach

consumers
Located around
centre
clinic
reach
in the city
outlying
areas
fortoease
of
consumers
in
the
outlying
areas
for
ease
of
management
management
Serving
populations between 100000 200000
Serving populations between 100000200000
The
location should have basic health care
facilities
The location should have basic health care
facilities
&good
access to community centre from
&good
access to community centre from
nearby villages
nearby
Staffedvillages
by an Ophthalmologist and support
staff
Staffed by an Ophthalmologist and support
staff layout is 8-10 lakhs
Capital
Capital
layout is
8-10
40%
of patients
paid
forlakhs
services of surgery
40% of patients paid for services of surgery

Located where population are approx.

50,000
Located
where
population
are approx.
within
5 km
radius/ approx.
100,000
50,000
5 km radius/ approx. 100,000
within
10within
km radius
within 10
radius
Aravind
Eyekm
Care
has 36 such centres
Provides
Aravindsustainable
Eye Care has
36 location
such centres
fixed
eye care
service
Provides sustainable fixed location eye care
service
Use
Trained staff and Tele-ophthalmology
Collaborate
Use Trained
staff
and Tele-ophthalmology
with
community
to create
awareness
Collaborate
with
community
create
and educate on eyetocare
awareness and
educate on to
eye care
Economically
advantageous
patients(
Economically
towages and
saves advantageous
travel cost, lost
patients(
saves travel cost, lost wages and
other
expenses)
other expenses)
Capital
layout required is 8-10 lakhs and
recurring
Capital layout
required
is usually
8-10 lakhs
and
expenses
will be
recovered
inrecurring
2 years expenses will be usually recovered
in 2 years

Service Delivery Options

Eye-Screening Camps
Eye-Screening Camps

Mobile Unit
Mobile Unit

For generating demand, mobilizing the

community
For generating
demand,
mobilizing
the
resources
to assist
service
community
resources
to assist
service
delivery
and build
Aravinds
image
build Aravinds
Indelivery
2009-10and
, Aravind
organizedimage
2148
camps,
In 2009-10
,
Aravind
organized
2148
screened 455,378 patients
and
camps,
screened
455,378
patients
and
carried out 76,056 surgeries
carried
outpatients
76,056 who
surgeries
Most
of the
received free
surgical
Most ofservice
the patients
who
received
free
were referred
through
surgical service were referred through
camps
campsmay be small, medium or major
Camps
depending
Camps may
be the
small,
mediumand
or major
upon
population
depending
uponnumbers
the population and
potential
patient
potential
Number
of patient
patientsnumbers
in a camp also depend
upon
Number
of
patients
a camp
depend
the sponsor andinthe
effortsalso
made
by
upon
the
sponsor
and
the
efforts
made
by
him
him

Launched in 2003, the initiative was funded by

World
Launched
in 2003,
the initiative was funded by
Diabetes
Foundation
Diabetesto
Foundation
It World
was equipped
take digital fundus image to
help
It was
equipped
to retinopathy
take digital fundus image to
detect
diabetic
helpprovided
detect diabetic
ISRO
satelliteretinopathy
based communication
facility
ISRO provided
satellite
based
between mobile unit
andcommunication
the base
facility
between
mobile
unit
and
the base
hospital
hospitalto serve 75 patients a day
Capacity
Daily
Capacity
to serve
patients
a day
running
costs 75
is around
4000-5000
INR
InDaily
running
costs
is
around
4000-5000
INR
2010,introduced mobile refraction unit which
helped
In 2010,introduced
mobile refractive
refraction errors
unit which
address uncorrected
in
helped
address
uncorrected
refractive
errors
spectacle dispensing units in the rural areas in
spectacle dispensing units in the rural areas

Service Delivery Options

Community
Community
Centre
Centre
Clinics
Clinics

10% patients referred

patients
referred
to10%
base
hospitals
for
to
base
hospitals
for
surgery and treatment
surgery and treatment

Vision
Vision
Centres
Centres

For primary treatments,

For primary
treatments,
patients
were referred
to
patients
were
referred
to
Vision centres
Vision centres

Base
Hospital
s

Refraction
Refraction
Van
Van

For advanced
For advanced
examination,
patients
examination,
were referred topatients
Base
werehospitals
referred to Base
hospitals

40% patients referred for

40% patients
for
surgery
paid forreferred
the
surgery paid for the
services
services

Eye
Eye
Screening
Screening
Camps
Camps

39% of free cataract

39% of free
surgeries
at cataract
base
surgeries
at
base
hospitals referred
hospitals
referred
through
eye-screening
through
eye-screening
camps
camps

Mobile
Mobile Unit
Unit

For surgical intervention,

For surgical
patients
were intervention,
referred to
patients
were
referred to
Base hospitals
Base hospitals

Creating Awareness and Acceptance

Community outreach program created awareness of the

importance
Community
ofoutreach
eye care program created awareness of the
of eye care
It importance
included distribution
of hand-bills and posters, shop hoardings,
loud-speaker
It included distribution
of hand-bills
and posters, shop
hoardings,
announcements
and announcements
on cable
TV
loud-speaker
announcements
and
announcements
on
cable
Referrals through local doctors, teachers, NGOs and village TV
leaders
Referrals through local doctors, teachers, NGOs and village
leaders
Study
was conducted to compare effectiveness of alternate
intervention
Study was conducted
to compare
effectiveness
alternate
strategies for
increasing
awareness ofHealth
intervention
strategies
forEconomic
increasing
awareness Health
Education
Approaches
and
Incentives
Educationlevel
Approaches
andhigher
Economic
Awareness
was found
only Incentives
where there was eye screening
Awareness
level
was
found
higher
only
where there was eyevan sites
screening
van
sites
Full
economic
incentive
system showed positive impact on
awareness
Full economic
levelincentive system showed positive impact on
awareness level

Key Challenges
The percentage of rural population served was considerably low
Inspite of immense efforts by Aravind Eye Care, the uptake could not even reach 10
percentage of population who needed eye care
Providing access to the eye care service was alone insufficient to meet their objective of
reducing needless blindness
Rural population usually gave low priority for eye care treatment

Fear of surgery and poor acceptance are other major cause for concern

Women are less likely to attend an eye camp than their male counterparts

Recommendations
Increase Accessibility:

Establishing more vision

centres and try to shift the
health seeking behavior from
camps to vision centres

Promote through
Influencers:

Spread awareness among

people(age group: 25-35) who
can influence the potential
patients (age group: above 60)

Target
Target Women:
Women:

Leverage Technology:

Banks and MFIs can act as a

Banks and MFIs can act as a
liaison to approach SHGs and
liaison to approach SHGs and
organize eye camps for them
organize eye camps for them

Set up a toll free call center to

address customer enquiries.
Dial automated IVR calls for
information about post
operative care

Recommendations (Contd.)
Establish personal
connect:

Advertising Campaigns:

Including respective
paramedical staffs who belong
to that particular locality when
you organize a camp will
increase confidence

Since rural population have

more affinity towards movies,
rope in actors for adcampaigns to spread
awareness about eye care

New Channel :
New Channel :

PDS Shops (Ration shops) can

PDS Shops (Ration shops) can
be used as a channel to
be used as a channel to
distribute handbills and to
distribute handbills and to
communicate the dates of eye
communicate the dates of eye
camps being organized
camps being organized

THANK YOU
Intelligence and capability are not enough. There
must also be the joy of doing something beautiful.
Being of service to God and humanity means going
well beyond the sophistication of the best
technology, to the humble demonstration of courtesy
and compassion to each patient.Dr.G.Venkataswamy