Recognizing Eye Health as an Integral Part of Children's School Health Throughout the World

Abstract

T here is global recognition that delivering eye care is essential to achieving Sustainable Development Goals. The United Nations' (UN) recently ratified resolution on Vision for Everyone 1 reaffirms that improved vision and optimized functional ability are essential to ending poverty (Goal 1); attaining healthy lives (Goal 3); ensuring inclusive and equitable quality education for all (Goal 4); achieving food security and improved nutrition (Goal 2); promoting inclusive and sustainable economic growth and productive employment (Goal 8), and reducing inequality within and among countries (Goal 10). The benefits of access to eye care accrue throughout life, and the earlier in life individuals can take advantage of eye care services, the better. Nowhere is this more apparent than in the pursuit of inclusive and equitable quality education (Goal 4), where trials have shown that providing eyeglasses to school children significantly improves educational outcomes. [2][3][4][5][6] Moreover, programs for the detection and treatment of refractive errors among school children have the potential to be highly cost-effective in all regions of the world. [7][8][9][10][11][12] Nevertheless, for school eye health programs to be sustainable, it is necessary to integrate them within the broader health care system. Further, in view of their potential impact on education and other areas, such programs must also be closely linked with ministries of education and other relevant government stakeholders.School Health and Nutrition programs offer an appealing platform through which to deliver eye care services. 13 The last decade has seen unprecedented growth in national school health and nutrition programs. An analysis by the United Nations World Food Program 14 in January 2020 found that more school children benefited from school health and nutrition programs than at any time in history. Around half the world's primary school children, some 400 million, received meals at school every day, and more than 95% of these programs used the school platform to deliver a range of other health services, often including eye health. However, by mid-2020, this decade of growth was brought to a shuddering halt when the COVID-19 pandemic resulted in the closure of schools worldwide and excluded 1.5 billion children from education. 15 This has caused the greatest education crisis in world history, and at the same time, suddenly deprived school children of basic health and nutrition services. Strenuous national efforts to cope and mitigate the effect of the pandemic soon showed that, whether countries were resource-rich or resource-poor, there was no meaningful substitute for the school system to reach young people. Today, a Coalition of nations 16 has emerged, currently including more than 60 countries and 42 international agencies, with the specific resolve to build-back-better school-based programs. Specifically, the goals are to restore school health and nutrition services to 2020 levels by 2023 and reach another 73 million children identified as mo...