Table 2 Applying the model in the field of eye care

Whilst the model has been designed so that it can be applied in any setting, our focus is improving equitable use of primary care services in line with the broader aims of Universal Health Coverage. Our group is in the process of field-testing the model in large community-based eye screening programmes operating in Botswana, India, Kenya and Nepal

Eye health is a major global public health issue and 90% of the 1.1 billion people with correctable vision impairment live in low and middle income countries [11]. It is thought that only around half of those identified with a need at screening actually attend clinic to receive treatment – which is close to the African regional mean for non-attendance across all service types [12]. Evidence is limited, but suggests that women, widows, and those from rural areas are the least likely to receive the care they need [11, 13]

The advent of smartphone-based eye assessment and the digitisation of vision screening programmes has made it much more affordable to rapidly screen and treat large populations. The most widely used digital platform is currently supplied by Peek; a social enterprise non-profit spin-out from LSHTM whose app-based programme has been rigorously evaluated [14,15,16,17,18,19,20]. Peek has agreements in place with international non-governmental organisations (NGOs), local NGOs and governments in twelve LMICs to support eye screening programmes that should reach tens of millions of people over the next decade [21]. Our group has been working with Peek to embed the IM-SEEN model into their processes and software. We anticipate that this method will allow local eye health system leaders to conduct rapid randomised controlled trials (RCTs) within their programmes to test incremental modifications aimed at reducing socioeconomic gaps in service provision, with the greatest gains seen in disadvantaged groups