Gender-related barriers to healthcare are not newfound. The gender disparities in eye health cannot be simplified. There are several complexities including decades of social conditioning that has led to the stark gap in accessing overall healthcare including eye health seeking behaviour of women. A lack of gender parity is not unique to India but can be found globally as well. Every two out of three blind people in the world are women.
According to the National Blindness & Visual Impairment Survey India 2015–19 conductedby AIIMS, New Delhi cataract continues to be the primary cause of avoidable blindness (66.2%). Women are also twice likely to go blind owing to bilateral cataract affecting the vision in both eyes in comparison to men. The prevalence of blindness and visual impairment due to bilateral cataract in men is 0.59% while in women it is at 1.09%.
Socialisation, earning capacity, access to financial resources, gender roles, power relation with the opposite gender, the idea of self-worth too have subliminally contributed to the gender disparity in eye health in India. There has been a significant stride in preventing avoidable blindness with the ongoing National Program for Control of Blindness & Visual Impairment (NPCB&VI). In 2007, the prevalence of blindness in women was at 4.1% while in 2019 it reduced to 2.31%. However, a lot needs to be done when it comes to eye health seeking behaviour of women with critical gaps to be filled to reduce the gender disparity.
Social barriers to accessing eye care services
Blindness is more prevalent in women in India yet their access to eye care facilities is less especially in rural areas. The social norms play a critical role in creating gender disparity for eye health. Spending time on household chores and tending to children, they mostly relegate getting their eyes tested for any ailment. Dependence on the male member to visit a healthcare facility is another reason for reduced access to eye care services. Less control over decision-making and lack of financial autonomy act as impediments to seek eye care services.
Greater risk of sight loss
Women have been found to be more prone to sight loss. As highlighted in the National Blindness & Visual Impairment Survey India 2015–19, the prevalence of blindness is much higher in women as compared to men. At 2.31%, the prevalence of blindness in women is higher than the national average of 1.99%.
Lack of significance attributed to eye care
An underlying thought has been that since people may not be critically harmed or die owing to lack of sight, getting a corrective surgery can be pushed back. Women also tend to not pay much heed to their own health vis-à-vis the health of other family members. Thus, the idea of self-worth tied with significance attributed to eye health needs further creates the divide in uptake of eye care services.
Limited awareness on eye health
A lack of awareness amongst women on eye health is a significant contributor toward gender disparity. Symptoms of cataract or glaucoma may not be known and often taken as age-related reality especially in the rural regions. A fear of surgery is another reason that women tend to refrain from getting corrective treatment done or delay it. Employing local community health workers and Accredited Social Health Activists (ASHAs) in creating awareness on eye health care may accelerate improved knowledge on eye health.
Bridging the gap
A gender responsive programming is essential to reduce the eye health gap between men and women. Raising awareness on addressing eye care needs of women not just in women but also male members of the family will be crucial in behaviour change towards uptake of eye health services. Sensitisation of community healthcare workers towards the need of women will enable the ecosystem to work towards making eye care services accessible to women. What also works is integrating eye care needs of women with the larger gender strengthening framework in society at large. The outcomes may not be achieved in a day, but collaboration, intent and action may lead us to not having to talk about gender disparity in eye health.
Views of the author are personal and do not necessarily represent the website’s views.
Mr. R N Mohanty is the CEO of Sightsavers India. He has more than 25 years of illustrious service in the development sector. Before moving into Sightsavers, Mr. Mohanty was the Chief Operating Officer of CARE India, the only other organisation he has worked for. His vision has brought the desired shift to the current programme and the resource mobilisation strategy of Sightsavers. The framework envisioned for the coming five years, emphasising reach, sustainable and preventive eye care, is being successfully implemented and has achieved significant milestones in a short span. In a life and career dedicated to the social development sector, Mr. Mohanty has handled every aspect of the sector’s work and has been richly rewarded with fulfilling assignments.