The purpose of this evaluation is to provide information to inform decision making around future New Zealand Aid Programme support for visual impairment activities in the Pacific. The evaluation focused on support provided by MFAT over 2006 to 2015, and also considered support provided by other donors and development partners, as well as visual impairment activities led by Pacific governments. It analysed the relevance, impact and sustainability of these activities, and made recommendations to inform future directions. The evaluation involved a contextual review of the eye disease burden and health system response, and interviews with 62 stakeholders in New Zealand, Australia and seven Pacific countries.
The evaluation found that the need for visual impairment services remains high and is compounded by a growing and ageing population, and the growing incidence and prevalence of NCDs. The health system response is multi-faceted and found to be high performing and providing the missing ingredients of successful system functioning. MFAT and its main implementing partner, Fred Hollows Foundation New Zealand, are critical actors in this system response.
The evaluation concluded that support for visual impairment activities is a priority when it has wider system impacts, beyond ophthalmology. As a long term investment, MFAT’s support has had positive impacts across workforce training and support, service delivery and leadership. The system that has been built is largely led and coordinated from outside national departments/ministries of health, and from outside of the countries themselves. It is very reliant on donor support. The evaluation concluded that if eye health activities are to be sustainable, they need to be better integrated into country systems before donor funding can be withdrawn.