ABSTRACT
OBJECTIVE: To describe the adaptation and scaling-up of an intervention to improve the visual health of children in the Apurimac region, Peru. METHODS: In a pilot screening programme in 2009-2010, 26 schoolteachers were trained to detect and refer visual acuity problems in schoolchildren in one district in Apurimac. To scale-up the intervention, lessons learnt from the pilot were used to design strategies for: (i) strengthening multisector partnerships; (ii) promoting the engagement and participation of teachers and (iii) increasing children's attendance at referral eye clinics. Implementation began in February 2015 in two out of eight provinces of Apurimac, including hard-to-reach communities. We made an observational study of the processes and outcomes of adapting and scaling-up the intervention. Qualitative and quantitative analyses were made of data collected from March 2015 to January 2016 from programme documents, routine reports and structured evaluation questionnaires completed by teachers. FINDINGS: Partnerships were expanded after sharing the results of the pilot phase. Training was completed by 355 teachers and directors in both provinces, belonging to 315 schools distributed in 24 districts. Teachers' appraisal of the training achieved high positive scores. Outreach eye clinics and subsidies for glasses were provided for poorer families. Data from six districts showed that attendance at the eye clinic increased from 66% (45/68 children referred) in the pilot phase to 92% (237/259) in the implementation phase. CONCLUSION: Adaptation to the local context allowed the scaling-up of an intervention to improve visual health in children and enhanced the equity of the programme.
Subject(s)
Faculty , Health Promotion/methods , Vision Screening/methods , Adolescent , Child , Child, Preschool , Community-Institutional Relations , Eyeglasses/economics , Humans , Peru/epidemiology , Pilot Projects , Referral and Consultation , Refractive Errors/epidemiology , Refractive Errors/therapy , Rural Population , SchoolsABSTRACT
Vismia genus is an important source of natural medicinal products, thus, information collected in this review is an attempt to cover the most recent developments in the ethnopharmacology, pharmacology and phytochemistry of this genus. Anthraquinones and other quinonoid derivates, terpenoids and volatile constituents have been reported as the major constituents isolated from different Vismia species. On the other hand, pharmacological studies carried out to date have revealed the variety of anti-plasmodium, antioxidant, antimicrobial and antifungical properties of extracts and pure isolated compounds of the different species tested. The information summarized in this paper intends to serve as a reference tool to practitioners in the fields of etnopharmacology and chemistry of natural products.
El género Vismia es una fuente importante de productos naturales medicinales, es por esto que la información reunida en la presente revisión cubre los estudios más recientes en la etnofarmacología, farmacología y fitoquímica de este género. Antraquinonas y otros derivados quinoides, terpenos y constituyentes volátiles han sido reportados como los compuestos mayormente aislados de las diferentes especies de Vismia. Por otro lado, los estudios farmacológicos realizados hasta los momentos muestran las diversas propiedades antiplasmodicas, antioxidantes, antimicrobianas y antifúngicas que presentan tanto los extractos como los compuestos puros aislados de las diferentes especies ensayadas. La información resumida en este documento intenta servir de material de apoyo para investigadores en los campos de la etnofarmacologia y la química de productos naturales.
