PALM Foundation

Better Vision Healthy Ageing Programme

Funded by: The Fred Hollows Foundation

Project cost Rs: 75,336,126.00

Project period: June 2012- June 2016

This is a collaborative project with government and NGO partners, with technical support and management from the Burnet Institute for Medical Research and Public Health in Melbourne.

Program rationale

Sri Lanka has the fastest ageing population in Asia. The proportion of older people is now increasing quickly because Sri Lanka achieved longer life expectancy and reduced birth rate soon after independence. The ageing of the population is happening at a much faster rate than occurred in richer countries.

Older people contribute significantly to their families and communities in emotional, social and economic ways.

Eye health problems, especially cataract and refractive errors, are more common among older people. Globally, more than 82% of the estimated 39 million people who are blind are older than 50 years. Women have a higher risk of visual impairment than men.

There is a great increase in diabetes, high blood pressure and heart disease in Sri Lanka. This is the result of new lifestyles and diets, as well as the increasing average age of the population. Diabetes, high blood pressure and heart disease make eye problems much more likely.

The impact of poor vision is greater on older people. They are often poor. They often have to cope with other health problems or disabilities. And they often have difficulties in reaching health care services.

Good sight enables better quality of life and allows older people to continue to play an active role in their families and communities. Social participation protects against many non communicable diseases and ageing-related conditions.

Poor vision increases the burden of care on families, especially women, and makes it more difficult for older people to prevent and manage their physical and mental health problems.

The desire to keep their vision can encourage individuals to prevent and better manage diabetes and high blood pressure.

Most causes of vision problems, such as cataract and lens problems, can be solved with a simple operation or spectacles. A few older people have eye problems that cannot be improved. But they can be helped in other ways to make their lives easier.

There is a need for more attention to eye health by elders, their families, their communities and government services.

Program goal and aims

The goal of the Program is improved health, vision and quality of life for elders in South and South-East Asia, and increased attention to vision within healthy ageing policies and programs.


To learn lessons about how healthy ageing strategies, such as the establishment of Elders' Clubs, peer education, and training of health care and social welfare providers, can contribute towards prevention and management of eye health problems.

To learn lessons about how healthy ageing strategies, such as the establishment of Elders' Clubs, can contribute towards the quality of life and health status of elders

To contribute to integration of prevention and management of eye health problems with the general health system.

To contribute to government efforts to re-orient health systems and services towards the needs of older people, and the prevention and management of chronic NCDs. For example, procurement systems need to include spectacles, intra-ocular lenses, and essential eye medicines. Health information systems need to include recording of visual acuity and eye screening. Health worker training, and referral and treatment protocols need to include eye health.

To advocate for greater attention to eye health within the international agenda for NCDs and healthy ageing.

To advocate for greater recognition that good vision contributes significantly to active and healthy ageing.

Program components

Component 1. Building capacity for service delivery

  • Strengthen capacity for prevention and care for eye health for older people in an integrated manner in NuwaraEliya district
  • Contribute to addressing the backlog of need for cataract surgery and spectacles among older people in NuwaraEliya district

It is an important principle that research and advocacy programs should be accompanied by service delivery. Capacity for service delivery will be strengthened throughout Nuwara Eliya district, with a focus on Walapane and Nuwara Eliya DS Divisions, consistent with the strategies of Vision 2020 National Programme for Prevention and Control of Avoidable Blindness in Sri Lanka (2007 – 2012).

Component 2. Health promotion through healthy ageing strategies

  • Encourage and support attendance for screening, referral, and treatment
  • Address transport and communication issues
  • Raise awareness about preventing and managing chronic NCDs, especially diabetes, that predispose to vision problems
  • Encourage support and help for visually impaired
  • Improve social participation and quality of life
  • Support preparation for healthy ageing and good vision into old age

The key strategy will be support for Elders’ Clubs. Activities will be consistent with the MoH plan: Mobilising commitment and action to address non communicable disease 2011, and the National Action Plan on Ageing, 2011 – 2015, of the National Council for Elders, Ministry of Social Services.

Component 3. Research

  • Undertake operations research to evaluate new strategies for active and healthy ageing with improved vision
  • Undertake studies within the Program to answer specific questions
  • Disseminate the findings widely in order to influence policy and practice

Component 4. National and regional advocacy for eye health and healthy ageing

  • Raise awareness of the high prevalence and significant impacts of poor vision among older people
  • Showcase a best practice example of the potential of healthy ageing strategies, including Elders’ Clubs, to contribute to better vision for elders
  • Advocate for the need to integrate eye health as primary health care is adapted to the increasing need to address chronic NCDs and healthy ageing

Component 5. Extending Program activities to Myanmar and Indonesia