Women in low and middle-income countries face deeply held cultural norms that prevent them from safely accessing vital eye care services.
Currently, 55% of the world’s blind are women. Women are 8% more likely to be blind than men and 15% more likely to have the most severe forms of vision impairment.
expectations of them to manage household duties often prevail, preventing them from participating in care that takes them away from home for several days such as cataract surgery
In an effort to bridge the divide The Fred Hollows Foundation, in partnership with the Tilganga Institute of Ophthalmology in Nepal, implemented a one year trial that introduced several incentives for rural Nepali women to get their eyes screened. Known as the Nepal Gender Pragmatic Trial (NGPT), it was fully funded by the Australian DFAT under the Australian NGO Cooperation Program (ANCP).
The NGPT found that providing a travel subsidy, in combination with delivering awareness-raising activities and adjustments to eye care, significantly increased women’s uptake of services at rural eye care facilities.
The Foundation’s Research Director, Dr Sarity Dodson, said that deeply held cultural norms remain powerful barriers to achieving equity in eye health outcomes.
“A significant proportion of women reported that regardless of subsidies or improvements in the way we deliver eye care, expectations of them to manage household duties often prevail, preventing them from participating in care that takes them away from home for several days such as cataract surgery,” Dr Dodson said.
“COVID-19 was a gendered pandemic. While men are more likely to die, additional burdens have been placed on women who have had most of the responsibility for care giving, both at home, and in the wider health sector.
“Fred Hollows once said, ‘inequity diminishes us all’. Overcoming deeply held cultural norms is the biggest challenge of our time but will be key to unlocking women’s access to eye care, other health services and participating in broader society.”
The Foundation will use the study results to inform a new five-year strategy for eye care work in Nepal and other low and middle-income countries.
Read more about the Nepal Gender Pragmatic Trial.
Case Study – Chini, Tashi And Suna
Thanks to initiatives like the NGPT, women like 74-year-old Chini Lama, 70-year-old Tashi Dolma, and 80-year-old Suna Luma, who have been inseparable since childhood, were able to travel to the Tilganga Institute of Ophthalmology to have their eyes screened.
Luckily for Chini, her children took responsibility of caring for her. Usually in Nepal, people who suffer from poor vision and blindness are shut away, kept inside, and depend completely on their family to survive. Despite her children’s constant love and care, Chini just wanted to have her life back.
“After having problems with my eyes, I can’t do anything by myself. Even cooking is hard to do,” Chini said.
“I just want to be independent and go out by myself again.”
Her sentiment is shared by her friends, Tashi and Suna, who want to tend to their farms and go walking without the fear of falling over or getting lost.
Luckily for the three best friends, personal friend of Professor Fred Hollows Dr Sanduk Ruit, and the Tilganga Institute of Ophthalmology were able to help.
After successful sight-restoring surgeries, the three women were able to return to their families, farms and friendship – tending to their farms, going on walks and admiring their village.
Photo: Chini, Tashi and Suma post-cataract surgery.