Aravind Eye Care System, Seva's partner in India, is the single largest eye care provider in the world, but they didn't get there just by helping themselves. This multi-part series examines Aravind’s external capacity building activities and the impact they have had on the organization itself. In this post, we discuss what capacity building is and why it is necessary in the realm of eye care.
Most people, especially those in the developing world, have limited access to health services. Nowhere is this more abundantly clear than with eye care. 39 million people worldwide are blind, with nearly 51% of these cases caused by cataracts. Cataract surgery is viewed as one of the most cost-effective health interventions, but unfortunately, many do not have access to this simple procedure.
When the quality of care is poor, it can be both harmful and costly. Even when the quality of care is high, resources are often overused, misused or underused. This can place a heavy financial and human burden on health care systems, particularly those in low-income countries. Unfortunately, even when institutions believe that improvements are possible, it is often difficult for them to improve without external assistance. This is why many healthcare organizations look to experts to assist them in building or improving their capacity.
Capacity building is fundamentally about improving effectiveness, at the micro and macro organizational levels. Capacity building focuses on furthering an organization’s ability to do new things and improve what they currently do. Most simply, capacity building improves the organization’s performance and enhances its ability to function and continue to stay relevant within a rapidly changing environment.
Capacity building typically involves training, mentoring and financial and/or other resource support to individuals and organizations from external sources. Capacity building does not happen overnight. It is a process that may take several years, and often involves experts from many fields. Typically capacity building will result in the adoption of new skills and knowledge as well as systems to sustain and expand these improvements over time.
Capacity building is particularly important in dealing with the improvement of eye care service delivery. At many eye hospitals in developing countries, surgeons are providing high-quality care but are operating at an extremely low capacity level, often performing no more than 1–2 surgeries a day. With improved clinical and administrative training and better hospital patient care systems, it has been proven over and over again that ophthalmologists can dramatically improve their surgical output to at least 8–10 surgeries per day.
Hospitals are complex organizations. Besides serving as a place to treat the sick and injured, many hospitals function as research institutions, training facilities, and large employers. In addition to medical expertise, administering a hospital requires knowledge of business management, finance, information technology and human resources. Many hospitals in low-income settings lack individuals with even the most basic of these skills. Doctors with little or no administrative experience are put in charge, having to balance the demands of running a hospital with their own patient care responsibilities. In some cases, because of a shortage of properly trained administrative assistants, ophthalmologists could spend an inordinate amount of time conducting routine clerical and administrative tasks. Eye hospitals working in difficult environments deal with many of these challenges, with limited access to the expertise necessary to make substantive improvements.
As the largest eye hospital in the world, Aravind Eye Care Systems (AECS) is committed to the elimination of worldwide blindness. AECS’ founder, Dr. G. Venkataswamy (Dr. V) believed that it was both the responsibility, and the mission, of individuals and the organization to share best practices with other institutions. To this extent, Aravind staff work up to two years with hospitals both in India and outside the country helping them to adopt the best practices that drive the Aravind model. To date, AECS has mentored 245 hospitals in 25 countries, including India.
In addition to sharing best practices, Dr. V. also believed that AECS must continue to improve its own practice by learning from other institutions. This mutually beneficial approach of external and internal capacity building is a driving force of AECS’ growth and development and is the central focus of this research.
Our next blog will explore the evolution of AECS’ external capacity building.