Integrating eye health into a child health policy in Tanzania: global and national influences

Global consensus has shifted to focus on how children can be supported to not only ‘survive’ but to ‘thrive’. Blindness and visual loss in early childhood undermine a child’s ability to thrive, affecting 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, and not politically prioritised. 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 part of the global WHO/UNICEF IMNCI strategy.

We conducted a qualitative policy analysis to explore enabling factors and barriers to this policy change. The interviews were semi-structured with key actors selected purposively and by snowball sampling including those with a role in child and eye health at national and global levels. We used an adapted Shiffman and Smith Framework to guide the interviews and analysis, and the Consolidated Criteria for Reporting Qualitative Research (COREQ) for planning and reporting.

This study shows how rapidly one country introduced its overall child health policy to include eye health, driven by good quality research and the collective action (cohesive policy community) which importantly included the decision makers (Ministry of Health actors). These developments coincided with the shift in the international agenda moving from ‘survive to thrive’ in child health which was leverage to include eye care in the national strategy.