The area is considered drought prone area and cultivation of greens is rare. Hence, there is a deficiency of staple food for the weaker sections which causes malnutrition and vitamin deficiency among them. The general health status, particularly of the disadvantaged groups of both the districts, is very poor because of poor economic conditions, geographical barriers, lack of communication facilities and inaccessibility to health and development services. The prevalence rate at Sonepur is 1.60% and 1.56% in Boudh district in comparison to Orissa State which is 1.40%.

Eye-care services for people affected by leprosy remains one of the priority areas of LEPRA Society in preventing disabilities of leprosy-affected people. It was also planned to extend these services to the general people. Considering the eye-care situation and needs in both the districts, LEPRA planned its intervention in eye care in Subarnapur and Boudh districts through the Comprehensive Eye Care Service Project popularly known as "Mahanadi Netra Chikischhalaya" (MNC) and entered into a partnership with Sight Savers International (SSI) in 2003. The Project intended to develop a self-sustainable model of comprehensive eye-care services, which will make quality eye-care services accessible to the poorest of the poor.
As far as the broad objective of the project (to provide a package of promotive, preventive and curative eye-care services through an integrated system of screening camps, health education and base hospital services to cover the project population) is concerned, the project has made satisfactory headway in this direction.

The access to and demand for services at this hospital is gradually increasing and this will reduce the backlog of the target area and support in reducing the blindness problem. People from poorer sections and inaccessible areas are, now, accessing the eye-care services. This has helped in reducing the avoidable blindness problem and helped in improving the socio-economic conditions of the people in the area.

Health Education

In order to sensitise and popularise preventive messages and services available in the area, 42 health education programmes for women groups, 38 programmes for school students and 69 audio-visual shows for general public were are conducted by the field workers. The World Sight Day was celebrated on 14th October each year in both the districts. One of the key strategies of the project was the introduction of availing services at a cost (both fully and partially) which continued to be the strategy of the project. The Project has been fairly successful in this aspect.
The project has already been evaluated by LVPEI, one of the premier Eye-Care Institutes of India. In their opinion, the MNC has a good set- up and provides quality surgery in the rural areas.
The project has developed networking with the community-based organisations and volunteers whereby cataract cases can be referred directly to base hospital for treatment.

School Screening and Refraction Programme

As a part of school screening activities, the technical team of the project visited 108 schools and screened 8996 school children out of which 2,011 children were provided spectacle services by prescription and spectacles. Further, 225 school teachers were trained on preliminary eye screening with a view to enabling them to conduct the same in their respective schools and refer problematic cases to the base hospital.

• To provide eye-care services free of cost or at subsidised rates to poor and needy population

• Improve staff capacity and outreach activities in community and schools for more case referrals to increase the cataract surgical rate

• To promote the prevention of nutritional blindness, detection and correction of refractive errors and enhance awareness of eye health in the project area

• To organise the capacity building for health providers in addressing visual impairment and referral of more cases
• Increasing partnership with local NGOs and CBOs and philanthropists for outreach programmes

• To conduct regular screening camps in the village/communities in the project areas providing OPD services including treatment and prescription

• To provide spectacle provision for needy persons

• Community-level IEC to create adequate awareness in villages and outreach area

• Advocacy with health authorities

• To develop the capacity of the teachers to identify the students with refractive error
• To motivate the surgically curable blind to access services at the base hospital

• Marketing strategy - Training facilities and service facilities
• Monitoring and evaluation to ensure quality