From disruptive idea to scaled solution: Community health workers have screened 10 million people for vision impairment!

Sixteen years ago, we trained 50 community health workers to identify people who need reading glasses to sustain their income. Today, more than 25,000 community health workers in Bangladesh, Uganda and Zambia have screened the vision of 10 million people through the Reading Glasses for Improved Livelihoods (RGIL) program. And, by the end of this year, two million people will see clearly thanks to their efforts! 

Developed by VisionSpring and BRAC in 2006, the RGIL program was the first to train community health workers (CHWs) to conduct basic vision tests, dispense reading glasses and refer for higher level services. The program de-medicalized the delivery of an over-the-counter product that had been stuck in optical shops and eye hospitals, making near vision correction more accessible for millions of people – from teachers and tailors to farmers and shop keepers.

At the time, this was both innovative and controversial.  

To some, it sounded great: Teach community health workers, mostly women, to identify the most common cause of blurry vision (presbyopia), enable them to earn income by selling reading glasses, direct more people into the health system for higher level eye care, and preserve the capacity of a limited number of optometrists and ophthalmologists for more complex eye conditions.

To others, it sounded alarming. Would health workers misdiagnose people? Would task-shifting diminish the optometry profession? Would the availability of a ready-made product erode earnings from upselling custom readers?

More than fifteen years and ten million vision screenings later, we have proven that this innovation is both effective and scalable; and is a key piece in the puzzle to solving uncorrected refractive error worldwide.

Winning over skeptics, we worked with BRAC to extend the program to Uganda in 2017. In 2021, we partnered with United Purpose to reach our final three districts in Bangladesh, such that RGIL provides national coverage. And this year, we are replicating the program in Zambia with Live Well.

And others have proliferated the practice too. Today, presbyopia is being identified and reading glasses dispensed by lady health workers in Pakistan (SightSavers), primary care nurses in Rwanda (Ministry of Health and Vision for a Nation), government community health assistants in Liberia (the Ministry of Health and EYElliance), and pharmacists in Bangladesh and Ghana (VisionSpring) and Kenya (Essilor/NVG 2.5). 

The RGIL program is borne from the thousands of people who dedicate their time, energy, and resources to ensuring clear vision for all:

Thank you to the Community Health Workers who serve their neighbors. 

Thank you to our team members who pour their talents and attention into the RGIL program: Khanindra Kalita , Anupam Sengupta , Chanda Chileshe , and Julius Mujuni. 

Thank you to our collaborators who have integrated RGIL into their community health services and make it work every day: BRAC , United Purpose , and CARE . 

And thank you to the funders who bridge the gap between what low-income consumers can pay and what it takes to deliver care: Cartier , Warby Parker and our unrestricted contributors.

Congratulations, all!