"They just want to stop feeling what they're feeling": A qualitative investigation and characterization of coping strategies for mental distress among adolescents in American Samoa.

There is a high magnitude of blindness and vision impairment in low-and middle-income countries, including India, [] highlighting the need for effective planning of eye care services. Shroff’s Charity Eye Hospital operates a network of eye care facilities in northern India using a pyramidal approach to eye care. [] The organization provides services in Uttar Pradesh, India’s most populous state in the north, [] through five secondary surgical centres in five districts, as well as more than 100 connected primary eye care centres (vision centres, [VCs]). These centres deliver primary eye care and refer patients to the secondary-level surgical centres. A national Rapid Assessment of Avoidable Blindness (RAAB) survey was conducted in India between 2015 and 2019, revealing variations in eye health outcomes by region, education, and age. [] The highest prevalence of blindness was observed in one district of Uttar Pradesh, but there was variation among the three districts selected from the state. One of the hospitals in our network is located in Lakhimpur Kheri district in Uttar Pradesh, which was not sampled as part of the national survey and lacked population eye health data. At the time of our study, this hospital was the primary service provider in its catchment area, with a network of seven VCs serving a population of approximately 2 million people. A plan was in place to expand services in the area, so to assess the need for eye care services in the population, we conducted a RAAB survey. [] in its latest digital format, RAAB7. [] Although Dr Shroff’s Charity Eye Hospital was the leading service provider, other eye care providers operated in the same area. Therefore, we aimed to understand our service delivery in the context of both the population’s needs and the services provided by other eye care organizations. To do this, we implemented the optional RAAB Health System module. The RAAB Health System Module, recently developed by the RAAB Steering Group members, allows for the collection of structured, facility-level data on the availability, capacity, and quality of services required to fulfil the needs identified in RAAB surveys. The Health System Module is an innovation that enhances RAAB by rapidly identifying gaps in current eye care services. This module collects information on policies related to eye services. It captures services offered by both government and non-government eye care providers for three common causes of vision loss: cataract, uncorrected refractive error, and diabetic retinopathy (DR). Since RAABs are typically conducted at the subnational level, this module provides a quick, user-friendly tool to support eye care planning within a survey area. While RAAB results can help estimate the burden of eye diseases, data on available services are also needed to plan at the district level. This module enables a relatively quick assessment of service gaps for cataract, refractive error, and DR services. The data to be collected in the module include the outputs and outcomes of cataract surgeries, the number of glasses dispensed, vision with glasses, the number of individuals screened and treated for DR, and the human resources at the respective centres providing services. This can support the planning needed to scale up services, improve service quality, and plan the workforce.