Sourcing acceptable spectacles
Spectacles are the simplest and most inexpensive way to correct refractive errors. Sadly, the cost of a pair of spectacles is out of the reach of most people in low- and middle-income countries. This is true even in countries with the capacity to manufacture and distribute spectacles.
One solution is for hospitals or governments to provide spectacles free of charge or at a minimal fee. However, this can use up available funds very quickly, which means fewer people can be helped.
In addition, most spectacles available commercially are expensive and access to them is limited. On the other hand, cheaper spectacles can often be of very poor quality.
Ensuring that spectacles are both accessible and affordable is therefore one of the key challenges facing any programme aiming to deliver refractive error services.
The non-governmental organisation (NGO) sector is a major consumer of spectacles. This offers a possible solution to the problem of sourcing acceptable spectacles: organisations can pool their spectacle orders and buy spectacles in bulk, thereby lowering their costs significantly.
Purchasing affordable and acceptable spectacles requires the following:
- knowledge of the market (knowing your environment and the trends that exist therein)
- ensuring that the product is cosmetically appealing
- knowledge about what customers can afford
- an easy-to-use and accessible procurement system
- coordination of efforts (because higher volumes drive prices down)
- warehousing and stock control
- open communication and networking.
The ICEE experience
Analysing the data from various projects can provide us with significant information on purchasing trends. This knowledge can then be used to make informed decisions.
In order to gain better knowledge of the market and to understand dispensing challenges, the International Centre for Eyecare Education (ICEE) analysed data from their project with the KwaZulu-Natal Red Cross Air Mercy Service and conducted a market analysis. In this project, a total of 4,458 patients were examined between 2005 and 2006 and 1,981 pairs of spectacles were dispensed. The dispensing patterns are depicted in Figure 1.
Other factors, such as the age of the patient and what the target market could afford, were also used to determine purchasing trends. Consultations with partner organisations resulted in a wealth of knowledge about current ordering volumes and prices.
As a result of this analysis, ICEE decided to create a system that would have the potential to address both African and global needs: the Global Resource Centre (www.iceegrc.org). The Global Resource Centre (GRC) aims to act as a centralised purchasing and shipping centre which allows like-minded organisations to pool their buying power. The GRC is a collaborative endeavour; it is supported by Sightsavers International (SSI) and Christian Blind Mission (CBM), and it is managed by ICEE. The GRC aims to:
- use large volumes to drive down unit costs
- use large volumes to drive down shipping costs
- eliminate the duplication of effort and resources between NGOs
- promote the tracking of worldwide trends to inform purchasing decisions and resource allocations
- be a single contact for the procurement of devices and equipment from multiple suppliers
- give both large and small customers access to spectacles at the same low prices
- ensure quality checks
- promote easy ordering of products via the web.
Pilot projects were conducted to test the GRC system. The key lessons learnt were:
- It is imperative to have offices and a distribution network in the country from which one is sourcing. This forms a critical part of the supply chain. Prior to the dispatch of every order, the products supplied can be scrutinisedto assure quality. New trends in products can be adequately assessed and exploited to the benefit of the programme.
- Transportation, shipping, and other costs need to be kept to a minimum, as an inexpensive product could become very costly by the time it reaches the purchaser.
- A huge stock (inventory) is required, which requires sufficient funds and space as well as stringent stock control. ICEE, CBM, and SSI are assisting with funding to address this issue.
There are two key aspects to sourcing affordable spectacles. The first is to have a one-stop system that addresses the issues of affordability, accessibility, and acceptability. The second is to know the patterns and trends within the target market, as this influences the financial outlay, the type of stock carried, and stock levels.