| Popis: |
Background Blindness and visual loss in early childhood can affect psychomotor, cognitive and social development leading to life-long consequences on educational attainment, employment, economic and social status, and wellbeing. Despite this, eye health for children under the age of five has been neglected, with little political priority as a child health issue. In Tanzania, policy makers decided in 2019 to include eye conditions in the national Integrated Management of Newborn and Childhood Illness (IMNCI) strategy, despite eye health not being in the global WHO/UNICEF strategy for IMNCI. Results We conducted a qualitative policy analysis to explore enabling factors and barriers to this policy change, using semi-structured interviews with key actors involved in child and eye health at national level and also explored if there were global level influencing factors. We found that the key determinants were the leveraging of existing policy communities and networks; clear consensus on framing of ideas within the policy and advocacy community and to policy makers; generating local evidence with policy communities; and a critical IMNCI policy window in Tanzania, together with the expansion of global child health policy which now includes early childhood development. Global governance structures, guiding institutions, and major funding or civil societies did not influence the policy change in Tanzania. Conclusions This study shows how child eye health advocates and funders can influence integration of eye health into the IMNCI strategy in one country. A global policy shift in child health to enable young children to ‘thrive’ as well as ‘survive’ provides a major window of opportunity in over 100 countries for eye health to be integrated into IMNCI and other national and global child health policies. Generating local evidence in collaboration with policy makers and child health policy communities, and a clear framing of the problems and their solutions will be critical factors in enabling the inclusion of eye health into child health policies. |
