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IWD 2016: Gender and Blindness

Did you know that two-thirds of the world’s blind are women?

For International Women’s Day, RIIO is focusing on gender and eye health.

What do we know?

Globally, women bear a greater burden of blindness than men.

  • A meta-analysis of population based surveys on blindness prevalence in Asia, Africa and industrialized countries indicates that women bear approximately two-thirds of the burden of blindness in the world.

Biology and gender inequalities combine to create these gendered health outcomes

  • The larger number of elderly females may contribute substantially to the excess female blindness in countries where women tend to outlive men. For example, age related macular degeneration, a disease with no effective treatment and the most common cause of blindness in developed countries, affects mostly those over 70 years.
  • In Asia and Africa, the major cause of blindness in cataract, which can be cured by simple surgery. Population-based surveys from five countries in Asia and Africa show that women account for between 53% and 72% of all people living with cataract. Further, women do not receive surgery at the same rate as men. Barriers that prevent both men and women from receiving surgery are often more problematic for women. They include:
    • Cost of surgery: Women often have less access to family financial resources to pay for eye care or transportation to reach services.
    • Inability to travel to a surgical facility: Women often have fewer options for travel than men. Older men may require assistance, which poorer families may not be able to provide.
    • Differences in the perceived value of surgery: Cataract is often viewed as an inevitable consequence of ageing and women are less likely to have social support in a family to seek care.
    • Lack of access to information and resources: Female literacy is often lower than male literacy, especially among the elderly. Thus, women are less likely to know about the possibility of treatment for eye disease or where to go to receive it.
    • Fear of a poor outcome: To this day, women are discouraged from wearing glasses in many societies. If cataract surgery does not have a good refractive outcome, women are more likely to be functionally blind than men after surgery.
  • Trachoma, another prominent cause of blindness in developing countries (though, fortunately not in Rwanda), is also more common in women than men. Since women and older girls are the primary childcare providers, they acquire active trachoma from young children.

What research is needed?

  • More population-based data from Latin America, South America and the former Soviet Union to evaluate the issue of gender and blindness.
  • Further research on how gender inequality influences blindness rates and access to care, all over the world.
  • Where the use of services is unequal, we need to test methods to rectify the imbalance.

What are the implications for policies and programs?

  • Awareness of the problem is needed to generate political will to address sex differentials and gender inequities in use of eye care services.
  • At the local level it is important to identify the barriers that prevent women from receiving eye care services and to design gender-sensitive programmes to reduce these. Peer motivators (for example, women talking to other women) are likely to be more effective than health workers in promoting the use of eye care services.
  • National and local prevention of blindness programmes should monitor cataract surgical coverage and trichiasis surgical coverage rates by sex as well as monitor surgical outcome of surgery by sex. Discrepancies discovered should be investigated.
  • Global awareness of, and local approaches to, improving gender equity in eye care services use will be critical steps in achieving the goals of VISION 2020.

Unless we make special efforts to ensure eye services for women the correctable disparities in blindness prevalence between men and women will continue.