The main objective of eye health systems assessments is to provide a comprehensive assessment of the key health system functions as they relate to eye health and their interactions in a given country, based on the World Health Organization’s health systems strengthening (HSS) building blocks. The focus is on rapidly examining all components of the eye health care delivery system to provide a basis for targeted programmatic work aimed at improving outcomes for eye conditions in the focus countries.

With the understanding that the effectiveness of eye service delivery can only be improved through a better understanding and strengthening of eye health system functions, the WHO developed the Eye Care System Assessment Tool (ECSAT) in 2015, which provides guidance for assessing the status of a country’s eye care and helps decision-makers to identify gaps and strengthen access to and quality of services.

A few years earlier, a similar tool, called the Eye Health System Assessment (EHSA) tool, was developed by a consortium of eye care and health experts coordinated by the International Centre for Eye Health (ICEH) at the London School of Hygiene and Tropical Medicine (LSHTM) with funding from Sightsavers. Both tools are based on the six blocks of the WHO framework for strengthening health systems and aim to identify strengths and weaknesses in eye care service provision within the wider health system context.

Across the different countries in West Africa and East, Central and Southern Africa, the tools have been employed as standalone or a combination of both. To date, nine assessments have been completed and disseminated (see reports below). We are currently working on EHSAs in Uganda, Liberia, and an update in Sierra Leone and reports will be shared in 2025.

Eye health Systems Assessments reports

• Read the eye health system assessment report – Zambia (2011)
• Read the eye health system assessment report – Ghana (2013)
• Read the eye health system assessment report – Sierra Leone (2013)
• Read the eye health system assessment report – Kenya (2017)
• Read the eye health system assessment report – Malawi (2017)
• Read the eye health system assessment report – Mali (2017)
• Read the eye health system assessment report – Mali (2017) in French
• Read the eye health system assessment report – Tanzania (2017)
• Read the eye health system assessment report – Senegal (2018)
• Read the eye health system assessment report – Senegal (2018) in French
• Read the eye health system assessment report – Mozambique (2018)
• Read the eye health system assessment report – Mozambique (2018) in Portuguese

Related peer-reviewed articles

• Read the peer-reviewed article – Strengths and weaknesses of eye care services in sub-Saharan Africa: a meta-synthesis of eye health system assessments (2020)

Other links

• WHO’s ESCAT tool
• LSTMH’s EHSA tool