<i>Bridging gender gap in eye care</i>
After decades of research and despite a global consensus on the need of gender sensitive policies; gender disparities in eye care services still exist in many countries including Bangladesh. Available global data on childhood blindness and visual impairment also demonstrate various dimensions of gender disparity in children's eye health. There is huge gap between the service uptake rate among boys and girls. Girls in Bangladesh are still more likely to get eye diseases because of negligence by their parents; girls are less likely to be seen by a doctor when they have eye conditions. They also receive less surgical treatments for their eye problems. This situation needs to be changed. Eye care planners, doctors and health professionals, community development organisations and citizens should play a role to decrease the risk of getting eye diseases and going blind, especially among girls and women. There is ample evidence that these inequities can be reversed. Efforts need to bridge the gap in information, training, planning, implementation and monitoring of eye care and community development programmes. Following strategies can be applied to increase the access to eye care by girls. Increase detection of girls with visual impairment Case detection of girls with visual impairment and blindness — needs to be enhanced as more boys are usually detected. Blind girls are frequently missed out because they are not reported by their parents due to prevailing stigma, negative attitude and other socio-economic constrains. Increase uptake of surgery by girls Uptake of surgery by girls is very low because of various factors including fear of surgery, social negative attitude towards girls, wearing spectacles. Health promotion, counselling and financial support is needed to increase the uptake of surgery by girls. Free cataract surgery for women and girls Bring parents of girl child and services together — outreach eye care programmes (camps) are useful to reach girls who are from poor socio-economic condition, live in remote areas and unlikely to access routine and static eye care facilities. Gender specific messages should be included in the publicity and awareness activities prior to the camp to ensure that girls are brought to the eye camps by their parents. Girls with visual impairment need to be counselled along with the family members, particularly male members (father, brother) who usually makes decisions. Increase awareness of childhood blindness and gender issues Community sensitisation on blindness in girls and mass communication highlighting the gender issues in children eye care is needed. Motivate women and girls to motivate other women and girls — using women and girls as advocate and promoter of eye health at the community level could be a good strategy to ensure girl's access to eye care. Make information available to women and girls about eye health promotion, treatment facilities etc. Increase support to eye care for girls Provide necessary extra support to increase access to services by women and girls. For example, providing free surgery scheme for girls or providing transport facilities to and from eye hospitals can increase the uptake of services by girls. Thus establishing specific support systems for girls and women (travel, counselling) can make the programmes more gender sensitive and effective. Planning, monitoring and research on gender and child blindness Conducting research and monitoring programmes through gender specific data can make them friendly to the target groups. Eye care programmes should be developed to address their concerns and needs. Gender strategies for eye care should be developed as part of a comprehensive plan of action. The National Eye Care Plan of Bangladesh needs to be reviewed for a gender analysis and incorporate a gender sensitive action plan. The writer is the Chairman of Child Sight Network and Consultant in international eye health and disability.
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