When Seva began in 1978 there was little information about the causes and prevalence of blindness. This motivated Seva to make a national blindness survey the first phase of its first project: The Nepal Blindness program with the Government of Nepal and World Health Organization.
The Nepal Blindness Survey proved to be instrumental in establishing what has become one of the most comprehensive national eye care programs in the world. Lessons Seva learned have been applied over the past decades through research collaborations around the world on epidemiological, health services improvement, clinical care, and policy priorities.
Apart from the importance of the research findings themselves, Seva notes that engaging in research:
Improves routine data collection and analysis
Builds the evidence base on key program interventions
Translates findings into service improvement
Creates confidence and competence of local eye care team
Produces preferred practices and journal publications
Supports evidence-informed advocacy
Seva has developed a systematic approach to embedding research into service programs while also increasing attentiveness to routine service data collection and analysis.
Starting with the basics, Seva participates with over 100 eye care institutions around the world in collecting their service data and conducting collaborative reviews of changes over time in service volume, quality, and institutional finances. These reviews help identify issues Seva and hospitals prioritize to learn more about through short and long term research. Routine data also are used by partners and Seva, as in the Seva Annual Report.
Seva partners are offered the opportunity to design, implement and learn from rapid cycle improvement methods. These projects have focused on core issues including understanding and increasing patients’ follow through on getting recommended sight-saving eye services, streamlining referrals from vision centers to eye hospitals, and promoting use of teleconsultation.
Additional research-learning activities include Rapid Randomized Control Trials which build a robust framework for studying and improving selected aspects of program implementation. One such project is to compare factors contributing to Vision Center success which can guide their optimal development as well as increase vision center service volume, quality and sustainability over time.
For several years, Seva has worked with public health research experts in India to conduct an in depth workshop on Operations Research Capacity Building. Eye hospital teams from Nepal and India learned how to frame and answer research questions that helped to improve services for patients in their community. The participating institutions have become proficient in the key steps needed to carry out operational research and to date have published a total of 6 journal articles on their protocols and findings.
Beyond service delivery research, Seva puts a priority on producing evidence to inform and influence eye care policy nationally and worldwide. Seva research has produced important global data to promote vision care as an economic development issue.
Seva conducted extensive analysis on The Economic and Social Cost of Visual Impairment and Blindness in India.
These efforts strengthen the global eye care and development community’s awareness of the compelling importance to address vision impairment. For example, more needs to be known on the impacts of vision impairment across agriculture, industry, and education. Resulting information would improve targeting of programs to reach more people.
Seva’s long-term focus on data generates evidence that ultimately makes eye care equitable and accessible. Research-based published findings, from the The Nepal Blindness Survey up to 2023’s “The case for investment in eye health: systematic review and economic modeling analysis”, have become a factor in WHO-recommended policies for eye health and the daily practices of hundreds of eye care programs around the world.
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