Eye care competency framework

The WHO Eye care competency framework (ECCF) is a tool that will provide a set of global comprehensive competencies and activities. This tool will enable the planning and development of the eye care workforce to be aligned to a recognized standard of competencies and activities and will assist with maintaining an effective eye care workforce in terms of composition, deployment, and ongoing availability to meet population needs. The ECCF can be used by education and training institutions, policy-makers and regulation authorities, eye care service providers, and non-governmental organizations.

The World Health Organization (WHO) recognizes the fundamental role of the eye care workforce in improving the outcomes of eye care services. The current global eye care workforce faces a number of challenges, influenced by local contexts, which include lack of full integration into the health system, limited workforce capacity, mismatch of workforce skills to population needs, and inadequate quality of care are among those hindering people from receiving the eye care they need. These challenges combined with gaps in current workforce planning and development tools have resulted in services that are not effectively aligned with population needs.

To address some of these challenges, WHO has developed the Eye Care Competency Framework (ECCF) as a critical tool through which the required workforce can be planned and developed. The ECCF is a tool that conveys the expected or aspired performance of the eye care workforce across primary to tertiary levels of health care, to enable a continuum of quality care and integrated service delivery that meet the needs of the population. It aims to be a foundation tool to be used as a comprehensive reference for workforce planning and development, that is flexible and can be applied to address context-specific needs and assist in defining a shared set of expectations with a common language. The ECCF can further be used as a source to guide practice standards, protocols, and performance appraisals.

The ECCF is an overarching tool designed to be applied to an eye care worker in any context. It builds on and complements the work of existing frameworks such as the WHO Global Competency Framework for Universal Health Coverage (2022) (5), WHO Rehabilitation Competency Framework (2020) (6), and WHO Core Competencies for the Eye Health Workforce developed for the Africa region (2019) (7). The ECCF is supported by accompanying guides, which allow for adaptation and contextualization to reflect different areas of expertise and levels of practice. It can be used by education and training institutions, policy-makers and regulation authorities, eye care service providers, and non-governmental organizations.

The ECCF presents the competencies and activities of an eye care worker through six domains: Practice, Professionalism, Learning and Development, Management and Leadership, Community and Advocacy, and Evidence. Within these domains, each competency and activity is underpinned by knowledge and skills. Behaviors and tasks for each competency and activity are expressed (respectively) at different levels of proficiency. An eye care worker may identify with different levels of proficiency across each competency or activity within a particular domain; this will depend on their education and role requirements and is not specifically linked to their occupational group.

The Guide further describes and links the following four new tools developed by WHO to support country planning:

1. Eye care situation analysis tool (ECSAT)

Purpose: Questionnaire based survey tool to comprehensively assess eye care in a country.

2. Eye care indicator menu (ECIM)

Purpose: List of recommended eye care indicators to be collected regularly.

3. Package of eye care interventions (PECI)

Purpose: Planning and budgeting for eye care at each health system level.

4. Eye care competency framework (ECCF)

Purpose: Planning tool for eye care human resources based on competencies.