Advancing Global Eye Health:  Progress and Insights from the Child Blindness and Low Vision Program in Northern Malawi, Southern Africa

Background Blindness and low vision in children remain significant public health concerns, particularly in low- and middle-income countries (LMICs) like Malawi, a key region in Southern Africa. These conditions are often underdiagnosed and undertreated due to limited access to specialized services, spectacles and assistive devices, posing critical challenges to health equity. The Childhood Blindness and Low Vision Program (CBLVP) in Northern Malawi aimed to address gaps through capacity building, advocacy, ensuring access to regular eye health and low vision assessments, and provision of spectacles and low vision devices. Methods Activities included setting up clinical low vision services at Mzuzu Central Hospital in Northern Malawi, followed up by conducting outreach screenings and assessments, and building capacity through training and mentorship. Advocacy efforts engaged stakeholders such as government officers, parents, teachers, and disability organizations to promote awareness and service uptake, and provide basic skills to support the use of vision by the children at school and home. A mixed-methods approach was employed to evaluate progress: quantitative data came from service records, including client statistics and device distribution, while qualitative data were collected via engagement interviews with stakeholders and beneficiaries. Descriptive statistics and thematic analysis were applied to identify key achievements, challenges, and areas for sustainability. Results The program established a dedicated low vision clinic serviced by a full-time optometrist/low vision therapist. Between 2022 and 2024, 2054 children were served; 370 (18%) received glasses, 70 received low vision services (3.4%), and 96 (4.9%) underwent surgery. Spectacles and low vision devices improved beneficiaries' quality of life, enabling better educational and vocational performance. Awareness campaigns, including radio interviews and social events, increased visibility and service uptake, particularly among persons with albinism. However, challenges included the lack of an admission policy for inclusive education, initially leading to unnecessary admissions to special education and unnecessary use of Braille instead of print-based learning. Conclusion The program successfully addressed service gaps, fostered sustainability, and developed a scalable model for low vision care in Malawi and Southern Africa. Future efforts should emphasize policy integration and increased public awareness to sustain and expand the impact.