Eye care center infrastructure and services in small regions

Abstract 

In a bid to ensure that the people of Hail have access to health care services, this project focuses on the construction of a new facility and refurbishment for the existing eye care center. It is evident that the lack of a well-equipped eye center in the area is a significant challenge for the patients with eye problems. For this reason, this projects aims at designing and constructing an eye department within the local healthcare center with specialization in eye care and treatment to ensure the locals have access to specialized treatment at an affordable cost. The initial phase assessed the healthcare issue/need, assessment of the target population (150,000 people), stakeholder analysis, and evaluation of the resources needed for the completion of the project. 

The major stakeholders include patients, financiers, policymakers, project leader, project workers, and the healthcare facilities. The project leader consulted the team members in a discussion group involving brainstorming and integrating ideas on the best approach to address the inadequate healthcare infrastructure specialized in eye treatment. The group concluded that the development of a new eye department in the local health facility and refurbishing the existing unit would address the identified problem. The team will undertake a prototype to determine the feasibility of the project and evaluate the possibility of its expansion to serve remote areas without similar health facilities. The completion and implementation of the project will take three years with the expected outcome being an increase in the number of patients seeking eye care service and an increase in the quality of eye treatment in the region.  

Introduction 

Health care is a significant service that national and local government face challenges in addressing. Due to the high cost of healthcare, individuals in the middle-class communities and lower experience the greatest health problems in the access to these essential services. According to Nema & Nema (2012), people living in rural areas have limited access to health services due to financial constraints and inadequate facilities. In Saudi Arabia, the vulnerable population of women, children, and the elderly experience amplified challenges. In particular, this problem is rampant in Hail, which is a small city in the north of the country. The Saudi government has shown dedication in improving the access to health care in rural areas. However, it is yet to achieve the anticipated results due to the high cost of establishing health care facilities. Specifically, the cost of construction, equipment, medicine, and health workers is high. Indeed, workers shortage is a critical challenge since the number of qualified ophthalmologist and eye care facilities in the country cannot cater for the high number of patients in need of these services. Accordingly, the development of an eye care infrastructure in Hail city is an imperative step towards the realization of better healthcare in the country. 

The basis of this project is the significance of healthcare facilities and infrastructure in the improvement of the national health quality and access (Umfress & Brantley 2017). This paper provides a description of the health issues, the goals, and objectives of the proposed project, and the expected outcomes of the project. In addition, a comprehensive analysis of the target population is provided to justify the health needs and rationale for the location of the project.

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Problem Statement 

The prevalence of eye problems such as glaucoma is a health issue of global concern. Unfortunately, the residents of Hail face such health problem and others due to the lack of specialized eye care and treatment as well as the absence of medical facilities. Undoubtedly, the Saudi government has invested in the improvement of the health sector with numerous healthcare facilities established across the country. Unfortunately, these centers lack an essential department to provide specialized eye care and treatment to the population. In particular, rural dwellers with eye problems incur high expenses as they seek health services in the cities. While the wealthy can afford this cost, the majority of the rural poor suffer in silence as they develop complex eye problems. Although the government has shown dedication to improving the overall health experience in the country, the lack of specialized eye-treatment centers has resulted in a failure to achieve the intended quality of healthcare in the country. The development of an eye center facility in Hail is an illustration of the need to ensure that the established health facilities provide comprehensive care including eye treatment. In addition, this will also ensure the poor residents of this remote region have a better access to quality and affordable health services. 

Project Description 

The implementation of practical measures is an ideal approach to addressing the health challenges associated with limited access and unavailability of specialized care in the community. Accordingly, this project proposes the development of a specialized, modern eye center that will address all eye-related problems in the recommended area. Based on the eye problem cases in Hail, a modernized eye facility will help ease the disease burden in the region by improving the quality of health services and life for the locals. The project aims at improving the access to eye health services by providing affordable Primary Level Eye Care services irrespective of the socioeconomic status of the patient. In the conceptualization of primary level eye care, this entails preventive, promotional, rehabilitation and therapeutic services that prevent eye-problem complexities and blindness (Rao 2015). 

This project has two significant interventions related to the improvement of healthcare services. Firstly, the project will establish a new eye care facility at Hail, which is a remote area without eye care services. Secondly, the projects will refurbish the eye department and infrastructure in the existing healthcare facilities. The renovation of this facility is important as it will change the community perception of the facility and increase the capacity to provide health care services for the residents. The location of the project is Hail, which is a rural village without access to eye care services. Indeed, it is evident that the establishment of this facility in the rural area will enhance equality in the access to health care services for the locals regardless of the economic disparities in society (Umfress & Brantley 2017). For the project to attain the set objective, the government should provide adequate funds to equip it as well as hire the necessary specialist. In this case, the facility will require ophthalmologists, optometrist, and opticians to facilitate the diagnosis, treatment, and management of patients with eye conditions (Garg, Reddy & Nelluri 2014). Additionally, these specialists will conduct educational campaigns to educate and inform the people about the risk factors associated with eye problems. 

Target Population 

The target population for the project is the residents of Hail region in Northern Saudi Arabia suffering from different eye conditions. The problem analysis for the project noted that this area experiences a high rate of eye diseases such as glaucoma and have limited access to health care services as well as experience financial constraints. The study indicates that eye problems account for more than a fifth of the health problems in the region. Statistics indicate that over 150, 000 people in the region have different eye conditions at different states of complexity. While the local health facility provides eye surgeries and other services, blindness is on the rise due to a lack of equipment, sufficient experts, and the prevalence of cataract and glaucoma. 

 

 

Project description:     Construction of a new and refurbishment of the existing eye center in Hail area	Performance   Indicators	Means of verification	Assumptions
Goal:   To develop a new eye health care facilities that will increase access to specialized and affordable care in the communities within   three years	Semi-annual monitoring of the work progress	Analysis of the city council records on health care facilities	Availability of resources and raw materials will influence the completion of the project
Purpose   To Increase the number of people with eye problems accessing eye care services	More than 80% of residents with eye problem receive specialized eye care services	Home visits to individuals suspected to have eye problems    Analysis of health data in various health facilities	Residents with eye conditions will visit the health facility for treatment
Component   objective    To improve the optical health of the Hail residents through the provision of  safe and effective eye services	Active participation of professionals in the provision of specialized eye care services	Monthly monitoring of the care providers activities	Financial support will facilitate the continuity and sustainability of the project
Outputs    Improved eye health      Better quality of   health     Increased access to quality and affordable eye care health services	A reduction in the number of people with complex eye complications within a year	Annual assessment of the prevalence of the health problem    Survey    Technical statistics	Positive contribution by stakeholders
Activities   Initiate more eye care centers in the community    Collaboration with partners for success    Conduct awareness campaigns in the community	Inputs:   Wages    Building material       Training services	Survey    Technical statistics	The collaboration of the stakeholders will positively influence service delivery    Government financing regulations

For the project to achieve the expected outcomes, the collaboration of the stakeholders is imperative. If the project will meet the demand of the target population and satisfy the expectations of the stakeholders, it will have fulfilled its mandate in the community (Buchbinder & Shanks 2012). While the stakeholder analysis helps in identifying the critical one, the process will be active throughout the project since new groups might emerge and affect or be affected by the project. As argued by Nash (2011), stakeholder identification is essential since they are an integral part of the decision-making process concerning the planning and execution of the project. In this project, the primary stakeholders include individuals and groups that influence project development such as the project team and manager, the functional management, the clients, and the sponsors. 

Stakeholder Analysis 

Policymaker: Saudi Arabian Ministry of health 

The policymaker in this project is the ministry of health in the Saudi government whose function is to establish a framework to guide the provision of quality and affordable care to the beneficiaries. In addition, the ministry collects data from the target population, the financiers, and the health providers for developing population-level metrics that are important in the development of health economic policies (Buchbinder & Shanks 2012). Apparently, data from the ministry is the primary source of information that helps in determining eligible population to receive these services, the mode of service delivery, the health issues of the community, and the accessibility of the health services. 

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Project Leader and Project Team 

The project leader is an important stakeholder responsible for the defining the plans as well as controlling and leading the project implementation. He or she will supervise the daily operations to ensure the project meets the standards and progresses as described in the projections. On the other hand, the project team provides their skills and knowledge by engaging in activities that facilitate the execution of the project (Nash, 2011). The project team will have two divisions: one refurbishing the existing eye care facility while the other constructs the new eye care unit. 

Sponsor 

The sponsor is an institution or company with the ultimate supervision powers and responsibilities to ensure the project completes as agreed with the contractor. The sponsor uses formal authority to oversee the project, guide the project team, and maintain project priorities. 

Patients 

The patients are the customers of the project, which targets approximately 150, 000 individuals with different optical health issues. The main function of the patients is to provide service requirements, funds, and receive the services. 

Other Stakeholders 

Firstly, the functional manager is responsible for the resources and policies that facilitate the completion of the project. Secondly, the technical manager ensures the project adheres to the set rules, regulations, and standards. The health care workers are also a part of the stakeholders responsible for service delivery as well as ensuring better health outcomes. According to Culyer (2014), the health care providers operationalize delivery of care within the policy framework and coordinate health care delivery with other healthcare professionals. The established health facility is another stakeholder since the hospital management team ensure total adherence to the principal objectives and achievement of the predicted goals. The hospitals will help in the identification of high-need patients, estimation of the cost of care, and implementing the program to reduce the operating costs. 

The project implementation will be in different phases spreading over a period of eight months as shown in the Gantt chart below. 

			Year  1						Year 2	Year 3
	Sept	Oct	Nov	Dec	Jan	Feb	Mar	Apr …
Project planning
Design and details
Identification of target population
Interviews with patients and care providers
Data presentation to the stakeholders
Materials availed at the sites
Construction work
Training sessions for care providers
Service delivery to the patients begin
Follow-up

 

Table 1: Gantt chart 

Monitoring and Evaluation 

Project monitoring is a critical activity where the project leader tracks the project progress towards the projected outcomes and goals. Specifically, this is the routine check of operations to assess the efficiency of resource usage and the attainment of the short-term objectives. According to Kerzner & Learning (2013), monitoring is a significant practice used throughout the project since it helps in internal decision-making the planning process. On the other hand, evaluation entails the collection and analysis of data to facilitate a comparison of the achievement with the expected results. Wysocki (2011) argues that evaluation helps in generating information about the impact as well as the cost-effectiveness of the project. The monthly evaluation report will indicate the monetary spending as follows. 

 

 

Details	Budget	Actuals	Variance
Fixed Costs	28000
Salaries		25000	3000
Rental Fee	3000	1000	2000
Advertisement	7500	8000	500
Recurring Costs
Advertisement	3000	2500	500
Training Cost	2500	3000	500
Wages	11000	12000	1000
Total	55000	51500	3500

The expected impact of the project is an escalation of patients receiving optical health care services in Hail and the surrounding area. Notably, the improved access and affordability of the service will influence the high number of patients seeking these services. A facility that specializes in eye care services will transform the public perception of optical care and increase the number of patients seeking the service. To demonstrate the effectiveness of the project, the ministry will prepare a comparison report showing the number of optical patients visiting the facility before and after the completion of the project. The ministry will also use interviews and surveys with the patient to evaluate the effectiveness of the project in meeting the community healthcare needs. Finally, an assessment of the scheduled activities will help to determine if the project adhered to the time schedule as planned.  

The project leader is responsible for the project evaluation, which assesses if all the project objectives are met. The evaluation also identifies the activities that facilitated the attainment of the goals and effectiveness of the project team in using the resources. Interviews are an integral part of this process to understand the community perception of the project and its sustainability. Once the monitoring and evaluation report is ready, the information is essential in ascertaining its feasibility. Ministerial reports on the effectiveness of the project over time will help in determining the duplicability of the project in other regions. 

Budget 

The estimated time for the project completion is three years. The project budget has three critical elements, which are the personnel, operating expenses, and fixed expenses. The table below shows the proposed budget for the project. 

		Annual costs			Total cost
		Year 1	Year 2	Year 3
Personnel	Direct	200,000	200,000	200,000	600,000
	Indirect	136,000	136,000	136,000	408,000
Fixed expenses	Stationary	1,000	1,000	1,000	3,000
	Legal fees	1,800	1,800	1,800	5,400
	Equipment’s	40,500	10,000	10,000	60,500
	Rent	70,000	70,000	70,000	210,000
	Furniture in eye care   center	50,000	10,000	10,000	70,000
Operating expenses
	Stationary	1,000	1,000	1,000	3,000
	Equipment’s	3,500	3,500	3,500	7,500
	Supplies	12,000	12,000	12,000	36,000
Recruiting-program-based expenses
	Training center	55000	55000	55000	165,000
	Advertising   expenses	3000	2000	1000	6000
Totals		573,800	502,300	501,300	1,577,400

 

References 

Buchbinder, S. B & Shanks, N. H 2012, Introduction to health care management, Jones and Bartlett Publishers, London. 

Garg, P Reddy, S & Nelluri, C 2014, Training the Eye Care Team: Principles and Practice, Middle East African Journal of Ophthalmology, vol. 21, no. 2, pp. 128–133. 

General Authority for Statistics Kingdom of Saudi Arabia, accessed 14 September 2018,  < https://www.stats.gov.sa/en/node >  

General Directorate Of health Affairs in Hail, accessed 9 September 2018, <http://www.moh.gov.sa/Directorates/Aljouf/About/Pages/Message.aspx> 

Kerzner, H. R., & Learning, I. I. F. (2013). Project management – best practices: achieving global excellence. Hoboken, N.J., Wiley. http://rbdigital.oneclickdigital.com. 

Nash, D. B 2011, Population health: creating a culture of wellness, Jones and Bartlett Learning. Sudbury. 

Nema, H. V., & Nema, N. (2012). Textbook of Ophthalmology, Jaypee Brothers Medical Publishers, New Delhi. 

Rao, G. N 2015, The Barrie Jones Lecture—Eye care for the neglected population: challenges and solutions, Eye (London), vol. 29, no. 1, pp. 30–45. 

Umfress, A & Brantley, M 2017, Eye Care Disparities and Health-Related Consequences in Elderly Patients with Age-Related Eye Disease, Seminars in Ophthalmology, vol. 31, no. 4, pp. 432–438. 

Wysocki, R. K 2011, Effective Project Management: Traditional, Agile, Extreme, John Wiley & Sons, New York.