Postgraduate Diploma in Community Eye Health

Purpose

The qualification aims to improve the delivery of eye care and blindness prevention activities in countries in the continent, by developing the capacity of national and district Vision 2020 managers to effectively plan and manage national and district Vision 2020 qualifications. The qualification focuses on the acquisition of knowledge and skills in assessing eye care needs and eye care resources, identifying strategies to meet the needs, and evaluating services within the Vision 2020 qualification.

The learning outcomes of the qualification are specifically linked to the learning needs of the learners in terms of the design and content of the qualification. The educational objectives of the qualification are to ensure that the learners are able to plan and manage national and district Vision 2020 qualifications. Specifically, the qualification assists the learners to collect and critically evaluate information relating to the burden of eye disease and blindness, to identify priority eye care needs in the district, to plan and manage strategies and activities to meet those needs, to evaluate eye care services, to work as a member of the health team, and to communicate effectively with others.

The qualification content modules have been specifically designed to meet the learning needs of learners who are or will become Vision 2020 managers at the district and national levels of care.

The organization and delivery of the curriculum allows for learner-centred and paced learning. It also allows for accommodating learners from diverse experiential backgrounds and infrastructural settings. Delivery of the qualification uses adult learning principles, which recognize that adult learners have prior knowledge and expertise, tutors and learners share responsibility in achieving outcomes and assessing learning, learners progress at their own pace with individualized tutor support, and learners have the capacity to draw on their knowledge and expertise and have the right to know what is expected. Learners also know that their learning will be applied to real life situations.

The qualification includes both on-campus and off-campus components i.e. it is mixed mode. This mixed mode delivery is an essential and integral component of the qualification design. The qualification takes into account the fact that health care providers are unable to spend extended periods away from their services and hence an effort is made to make the course accessible. This means that on-campus learning during a 10 week initial on-campus component is complemented by a 36 week off-campus component, during which learners are working back in their health districts and are supported by a tutor from the institution with whom they have e mail and telephonic contact, and then by a final 2 week on-campus component, during which learners have opportunity to report back on and share experiences. Hence, learners derive the benefit of a flexible qualification designed to place learning within the context of the districts in which they live and work.

The learning materials have been specifically selected to cover the course content and to meet the needs of the learners. The materials include print as well as electronic materials, which learners would be able to access from the internet and from WebCT/ Vula. Each module has been packaged to include units with specific learning outcomes. There are learning activities for each unit, with readings and resource materials (articles and textbooks) to which the learner is referred. Some of the materials have been included in the folder for the module.

The qualification is designed to allow learners to progress at a comfortable pace. The qualification extends over one year.

Rationale

The global Vision 2020 qualification was launched by the World Health Organisation (WHO) in collaboration with the International Agency For The Prevention Of Blindness (IAPB) in 1999, with the aim of eliminating all avoidable blindness by the year 2020. It is envisaged that it will be run by national ministries of health, in partnership with international non government development organizations (INGDOs). It is envisaged that each country will have a national Vision 2020 qualification that sets the broad strategic framework for the qualification, and that there will be a separate district qualification for each individual service unit of about 1 million population. A priority need that has been identified for the effective implementation of this global qualification is the need for human resource development in the continent. Within that need, the priority that has been identified is the need to train and mentor qualification managers. There are a number of training qualifications in Africa for secondary and tertiary level eye health care clinicians. There are training qualifications for Vision 2020 managers in Asia. There have not been any training qualifications for Vision 2020 managers in Africa.

Recognising this need, a number of INGDO members of the IAPB that are working in eye care and blindness prevention in Africa have sent selected qualification managers to Aravind Hospital in India for Vision 2020 management training. Whilst this has provided an important short-term option, it is recognised that this is not sustainable, and many of the models used in that training are inappropriate for the African context.

Also recognising this need, the International Centre For Eye Health at the London School Of Hygiene and Tropical Medicine obtained a grant from the Nuffield Foundation for the institution of Cape Town and Tunaimi University in Moshi, Tanzania. This grant is for five years, from 2005 to 2009. It provides funding for :

• Two learners from each centre to attend the one year Masters in Community Eye Health course at ICEH, to develop local training capacity.
• Ten learners from Africa to attend an annual eight week certificate course at each of University of Cape Town and Tunaimi University.

Visiting faculty to assist with the running of the courses at each of University of Cape Town and Tunaimi University.Employment of a part time course administrator at each of University of Cape Town and Tunaimi University.

The course at the institution is run by the division of ophthalmology and the course at Tunaimi University is run by Kilimanjaro Centre for Community Ophthalmology (KCCO). The first course at the institution was run in 2005, and 47 learners from 13 countries in Southern, Central, East, and West Africa have been trained. The first course at Tunaimi University was run in 2006, and 10 learners from 7 countries in East Africa have been trained.

As a component of the mid term evaluation of the certificate course undertaken in 2007 by the Nuffield Foundation, the INGDO representatives, the MOH representatives, and the present and past learners who were interviewed all confirmed the need that exists to provide this training. Two specific recommendations that were made to improve the training that is offered are:

• More time spent in health promotion, health education, operational management, and financial management.
• A system to provide supervision and support for a period after completion of the course.

The proposal to upgrade the existing eight week certificate course to a diploma course that comprises an initial 10 week on-campus component, with more time devoted to the modules identified, a 36 week off-campus component, with distance supervision and support, and a final 2 week on-campus component, meets these identified needs.

There are no plans to upgrade the course at Tunaimi University, and it is undecided if the present eight week certificate course at Tunaimi University will continue after 2009. The institution's diploma course will be the only one of its kind in Africa.

There are 42 countries in sub Saharan Africa, with a total population of 738 million. On the assumption that there should be a national Vision 2020 coordinator in each country and there should be a manager for each Vision 2020 qualification of 1 million, we would need to provide training for about 780 Vision 2020 coordinators and managers.

Recognition of Prior Learning (RPL)

The qualification supports the Recognition of Prior Learning. Recognition of Prior Learning is an area which is still being developed within the Health Sciences Faculty. Where applicable, the RPL process will be applied based on the current policy on RPL within the institution and faculty. RPL learners who are undertaking the qualification would need to approach the faculty office and would be directed to the qualification convenor. The qualification convenor would seek guidance and assistance in applying the RPL assessment process from the relevant staff in the Centre for Open Learning within the Centre for Higher Education and Development (CHED). A written report would be submitted to the qualification convenor, who would approach the Postgraduate Qualifications Committee and the Dean in making a decision regarding the RPL learner.

Entry requirements

The minimum entry requirement for this qualification is

• Bachelor of Health Sciences in Opticianry, NQF Level 7.

Or

• Advanced Diploma in Health Services Management and Leadership, Level 7.

Level, credits and learning components assigned to the qualification

Module name; NQF Level; Credits; Compulsory/optional; Year; Total credits per year

• Community eye health for Vision 2020; 8; 20; Compulsory;1; 20.
• Health promotion and human resource development for Vision 2020; 8; 10; Compulsory; 1; 10.
• Manaqement for Vision 2020; 8; 20; Compulsory; 1; 20.
• Implementation of district Vision 2020 qualification; 8; 14; Compulsory; 1; 14.
• Administration and management of district Vision 2020 qualification 1; 8; 16; Compulsory; 1; 16.
• Administration and management of district Vision 2020 qualification 2; 8; 16; Compulsory; 1; 14.
• Monitoring and evaluation of district Vision 2020 qualification; 8; 14; Compulsory; 1; 14.
• Planning for future Vision 2020 qualification; 8; 10; Compulsory; 1; 10.

Critical Cross-Field Outcomes (generic to all teaching and learning)

1. A comprehensive and systematic knowledge base in community eye health, and a depth of knowledge in the management of district Vision 2020 qualifications.
2. A coherent and critical understanding of the principles and theories of community eye health; an ability to critique current research and advanced scholarship in Vision 2020 qualification management; an ability to make sound theoretical judgments based on evidence and an ability to think epistemologically.
3. An understanding of a range of research methods, techniques, and technologies, and an ability to select these appropriately for a particular research problem in the field of community eye health.
4. An ability to identify, analyse, and deal with complex and real world problems and issues in community eye health, using evidence-based solutions and theory-driven arguments.
5. Efficient and effective information retrieval and processing skills, for the identification, critical analysis, synthesis, and independent evaluation of quantitative and qualitative data in community eye health; and an ability to engage with current research and scholarly or professional literature in the field of community eye health.
6. An ability to present and communicate academic/professional work effectively, catering for a range of audiences by using a range of different genres appropriate to the context.

• The initial on campus component comprises 42% of the notional hours, the off campus component comprises 50% of the notional hours, and the final on campus component comprises 8% of the notional hours. 50% of the summative assessment will be from 10 written tests during the initial on campus component, and 50% will be from 10 assignments and a written exam. This allocation is considered appropriate for the mode of delivery of the qualification.
• The learners will write a test at the end of each week during the initial on-campus component, and these marks will be given to the course faculty. Similarly, the results of the assignment at the end of the initial on-campus component will be made available to the course faculty. The tutors will then be in regular contact with their assigned learners during the off-campus component, and any problems will be discussed with the other tutors.
• Learners need to obtain a minimum mark of 50% for each of the initial on-campus assessments and for the first assignment, in order to obtain a "duly performed" (DP) certificate, to be able to proceed with the submission of the summative assignments and the sitting of the final exam. The assignments and the exam are marked by the tutors, and these marks are discussed at a meeting of all the tutors. The final marks are reviewed by an external examiner.
• Reports of external moderators are taken into account by the qualification convenor and by the tutors to ensure that the curriculum and teaching are aligned with the learning outcomes of the qualification. At the end of each year, the reports are discussed and the course materials may be revised to inform the future needs of the qualification.
• Learners will have the option of attending any one or a combination of more than one of the initial on campus 10 weeks that make up the first 3 modules. If they attend an individual week but fail to pass the end of week test, they will be given a letter of attendance from the Division of Ophthalmology. If they attend an individual week and successfully pass the end of week test, they will be given a letter of attendance and successful completion from the Division of Ophthalmology. This can then count as credit towards future qualification for the Diploma.

Integrated Assessment

Formative assessments at the end of each of the on-campus weeks provides for continuous assessments and the identification of non-active learners during this component of the qualification. The marks for these assessments are tracked, and in this way non-active or at-risk learners can be identified and assisted. During the off-campus component of the qualification, learners are in regular contact with their tutor, when problems can be identified and appropriate remedial action taken.

Combined formative and summative assessment during the initial on campus component

This will comprise 2 parts

• Theory; There will be a one hour written test at the end of each on-campus week. These tests will examine the material that has been covered during the week. Learners will receive feed-back from these tests. Each module test will count 5% towards the final mark (a total of 50% of the total mark for the 10 weeks).

If a learner fails to achieve a minimum achievement mark of 50%, she will have opportunity to repeat that test.

• Practical; During the initial 10 week on-campus component, using the material learnt during the modules, a district Vision 2020 qualification one year operational plan will be prepared according to a set format and using a set planning matrix. It will be presented and submitted for marking at the end of the initial 10 week on campus component. Learners will receive feedback on the plan submitted. It will count 10% towards the final mark.

Final summative assessment during modules 5-8

This will comprise 3 parts

• Progress reports (8 reports in total) will be submitted during the 36 week period of qualification implementation, summarizing-successes/achievements during the previous period, barriers/problems/obstacles during the previous period, and plans for the next period. These progress reports together will count 20% towards the final mark.
• A summative assessment will be written at the start of the final on campus component. This will count 15% towards the final mark.
• A one year operational plan and a five year strategic plan for the next period will be submitted at the end of the final on campus component. This will count 5% towards the final mark.

The explicitness, validity, and reliability of the assessment practices will be ensured by

Explicitness; the course handbook contains the overall learning outcomes of the qualification, the learning outcomes for each of the course modules, and the learning outcomes for each of the periods in the course modules. The learners can refer to this handbook, and the assessments are based on these learning outcomes. Validity; the module tests, the assignments, and the final exam are aligned with the learning outcomes, and the course convenor checks the content of the module tests and the final exam to ensure this. An external moderator checks the content and the marking of the module tests, the assignments, and the final exam. Reliability; the module tests, the assignments, and the final exam are marked using memos and grading tools. The institution also has an external examination system that requires that at least 50% of the marks that are submitted for each course are moderated by an external moderator. Module tests are marked by the module coordinators and the marks are recorded by the qualification administrator. Marked test scripts are given back to the learners, for them to check their marks. If they have any queries, the module coordinators recheck the marking. Similarly, the assignments at the end of the on-campus component and at the end of the off-campus component are marked by the tutors and the marks are recorded by the qualification administrator. If the learners have any queries with their marks, the tutors recheck the marking. The final marks are sent to the Postgraduate Qualifications Committee in the Health Sciences Faculty for approval. In the event of a dispute, learners who are dissatisfied with the marks allocated to them may appeal to the course convenor and the Postgraduate Qualifications Committee.