The goal of this interventional comparative study is to see if one day eye health orientation to Female Community Health Volunteers will increase footfall of patients in a Vision Center. Total of 58 Female Community Health Volunteers of Dipayal Silagadhi Municipality will receive eye health education. There is one Vision Center at Dipayal Silagadhi. Similarly there is one Vision Center at Chainpur Bajhang. Here FCHV will not receive one day eye health orientation. Currently both Vision Centers provide similar number of services. We shall compare and see if there will be any change in the number of people coming to these vision center.

Female Community Health Volunteers in Dipayal Silgadhi will be asked to refer eye patients to the nearest Vision Center. They will be given

1. Eye health orientation session
2. Referral slip

Every year thousands of FCHVs receive orientation on eye health. These training sessions are organized by eye hospitals and eye centers. There is a belief that FCHV play vital role in bridging the gap between community and health providers. Eye hospital staff also feel that training FCHV helps connect with community. Some centers conducts FCHV training program just before surgical camps. It is assumed that doing so increases the community people attending the camps. Despite the existing practices little is known about the effectiveness of eye health orientation to FCHVs. This study will help to find out the result of orientating FCHVs on eye Health.

This study aims to evaluate the effectiveness of a one-day eye health orientation provided to Female Community Health Volunteers (FCHVs) on the utilization of eye care services in rural Nepal. The intervention is facilitated by Seva Foundation/Seva Canada Society, in collaboration with Geta Eye Hospital, the leading eye care provider in Sudurpashchim Province. Launched nationally in 1988, FCHVs play a critical role in linking communities to primary health services. Given their widespread reach and strong rapport with local populations, FCHVs are well-positioned to support eye care delivery, particularly in raising awareness and referring patients in need of services. While Seva Nepal and partners have oriented more than 3,000 FCHVs across Nepal, there is limited empirical evidence on the impact of such training. This study seeks to determine whether FCHV orientation leads to measurable increases in eye care service uptake and to explore optimal training

The study follows an interventional comparative study design. Study Population is FCHV's of Dipayal Silgadhi Municipality Doti District, Jayaprithvi Municipality and Chhabishpathivara Rural Municipality in Bajhang District. Convenience sampling method has been applied. The intervention group consists of 58 FCHVs in Dipayal Silgadhi Municipality (Doti District), where orientation will be provided. The non-interventional group includes 91 FCHVs from Jayaprithivi Municipality and Chabbis Pathibhara.

Inclusion Criteria: All the FCHVs in above mentioned municipalities whe are interested to take part in the study

Exclusion Criteria: FCHVs not interessted participate in the study.

Rural Municipality (Bajhang District). The populations served are comparable, approximately 5000

patients examined in each serving eye centers covering 34,000 to 36,500 people each.

The orientation session will last four hours and be delivered by an Ophthalmic Assistant trained in a

standardized Training of Trainers (ToT) format. Content will include the burden of eye diseases in

Nepal, common eye conditions, early detection, prevention, and available eye care services.

Training materials such as referral slips, pamphlets, and posters will be distributed. No incentives

will be provided for referrals.

Data collection will span one year, beginning from the day of orientation. Referral slips completed

by FCHVs will be collected monthly, and patient data including name, age, gender, presenting and

final visual acuity, diagnosis, and distance traveled, will be recorded at the Eye Care Centre level.

Pre- and post-training evaluations will also be conducted to assess FCHV knowledge improvement.

Key indicators include:

Change in patient footfall compared to the previous year

Number of referrals versus actual visits

Gender and age breakdown of referred patients

Comparison of referral in the intervention and non-intervention group

Data will be maintained securely in Excel and shared monthly with the project team. While the study is subject to selection bias, as municipalities were not randomized, the findings are expected to provide important insights. The anticipated outcomes are increased referrals, improved access across gender and age groups, and evidence of training effectiveness. Results will guide Seva and partner hospitals in determining the future scale-up of FCHV eye health orientation programs.

Inclusion Criteria:

• Female Community Health Volunteers of Dipayal Silgadhi Municiplality

Exclusion Criteria:

• Female Community Health Volunteers of other Municipalities

Female

Considering the nature of study there is no need for individual information