BELGIUM 

Demographics
Population: 11.267.910 (January 2016).
Live births per year: 122.300 (2015).
Percentage of population under 15 years: 15.6%.
Ethnicity: Belgians – 77%, Non-Belgians (French, Dutch, Poles, Moroccans, Italians, Turks, etc.) make up the remaining 33%.
Language: Official languages are Dutch (59%), French (40%), German (<1%).
Other languages spoken: Polish, Turkish, Moroccan, Portuguese, Congolese, Spanish, Indian, Greek, Algerian, Syrian, Vietnamese, Chinese, etc.
Life expectancy at birth: Men – 78.6 years, Women – 83.5 years, Total – 81.1 years.

Healthcare system
Type: The Belgium healthcare system is divided into state and private sectors, with fees payable in both, funded by a combination of social security contributions and health insurance funds.
With mandatory health insurance, patients are free to choose their own medical professionals and places of treatment.
Patients generally pay costs upfront and are reimbursed a portion of the charges for medical and dental fees, hospital care and treatment, maternity costs and prescriptions through their health insurance fund (mutuelle / ziekenfonds).
Some alternative treatments are also reimbursable if carried out by a qualified doctor.
Many people top up their cover with private insurance to get a full refund of all medical costs.
Cost to patient to see a primary care doctor/general practitioner:
25 Euros (patient pays four to six Euros himself).
Cost to patient of squint surgery under general anesthesia:
Between 300 Euros (first operation) and 750 Euros (reoperation) per eye (patient pays nothing for the operation if he doesn’t ask for a private room and if he has public health insurance), the hospital costs will be around 85 Euros.

Paediatric ophthalmology Around 25 paediatric ophthalmologists (not a recognized subspecialty).

Major successes
1) Reopening of Orthoptic education in Liege, Wallonia in September 2016 (in French)
2) Screening program for amblyopia, strabismus and refractive errors
a) Screening of babies
In Flanders : at age 12-15 months, 24-30 months (since 2013)
In Wallonia : once between 18 and 47 months
b) Screening when children go to Kindergarten (more than 50 years already)
In Flanders in first (3 years) and second year (4 years) of kindergarten
In Wallonia in first (3 years) and third year (5 years) of kindergarten
c) Screening when children go to primary school
In Flanders in first (6 years) third (9 years) and fifth year (11 years) of primary school
In Wallonia in second (7 years), fourth (10 years) and sixth year (12 years) of primary school
d) Screening when children go to secondary school
In Flanders in first (13 years) and third year (15 years) of secondary school
In Wallonia in second (14 years), fourth (16 years) and sixth year (18 years) of secondary school
In Flanders in first (13 years) and third year (15 years) of secondary school
In Wallonia in second (14 years), fourth (16 years) and sixth year (18 years) of secondary school

Major challenges
After closing the Orthoptic education in 2011 in Flanders (in Dutch) it was very difficult to start a new program again.
There are increasing numbers of elderly strabismus patients and patients with binocular vision problems.
There is a strong optometry association (±5000 optometrists) with only 75 working orthoptists and ± 1000 ophthalmologists.

World Society of Paediatric Ophthalmology and Strabismus
Temple House, Temple Road, Blackrock, Co. Dublin, Ireland

Phone:+ 353 1 288 3630
Fax:+353 1 209 1112
Email:wspos@wspos.org

World Society of Paediatric Ophthalmology and Stabismus is a registered Charity with the U.K. Charities Commission (Charity Registration Number ;1144806) (Registered November 2011)

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