What can we do?
A south-to-south initiative to improve utilisation of eye care services
The evidence:
i) Women account for 65% of blind people in the world.
ii)In all age groups over the age of 50 years women have a 1.4 excess risk of blindness compared to men
[Abou-Gareeb I, Lewallen S, Bassett K, Courtright P. Ophthalmic Epidemiology, 2001; 8:39-56]
iii)Women consistently have lower rates of utilisation of cataract surgical services compared to men
[Lewallen S & Courtright P, Bulletin of the World Health Organization, 2002; 80:300-303)
iv)Women bear about 75% of trachoma related blindness
[Evans T & Ranson M. International Ophthalmology, 1995;19:271-80]
v)The barriers that restrict use of eye care services by men and women are different.
[multiple studies]
vi)Young girls blind due to congenital cataract are much less likely to be brought to hospital for surgery
[KCMC Hospital & CCBRT Hospital, Tanzania statistics]
Approaches to improving utilisation and achieving equity of eye care services & reducing blindness
i)Reduction of hospital based barriers to utilisation of services (e.g., “Karibuni Macho” programme at KCMC
Hospital in Moshi, Tanzania; Aravind Eye Hospital programmes in Madurai, India, Al Noor Foundation Eye
Hospital, Cairo, Egypt)
ii)Improving awareness, access, and acceptance of eye care services in a gender-sensitive fashion in the
community (e.g., Kilimanjaro Regional Eye Care Strategy in Tanzania)
iii)Counseling of eye disease patients to improve decision making and acceptance by family members—
particularly for elderly females. (Lumbini Eye Care Programme in Nepal, Aravind Eye Hospital in India, and
Kilimanjaro Regional Eye Care Strategy in Tanzania)Participating institutions:
Al Noor Foundation, Cairo, Egypt
Contact: Dr. Gamal ezz al Arab (arab@alnoor.org.eg)
Aravind Eye Hospital, Madurai, India
Contact: Dr. Praveen Nirmalan (Praveen@aravind.org)
BC Centre for Epidemiologic & Int’l Ophthlamology,
Vancouver, CanadaContact: Dr. Ken Bassett (bassett@chspr.ubc.ca)
Kilimanjaro Centre for Community Ophthalmology
Contact: Dr. Paul Courtright (kcco@kcmc.ac.tz)
Lumbini Eye Programme, Lumbini, Nepal
Contact: Mr. RP Kandel (rpkandel@wlink.com.np)
Seva Canada, Vancouver, Canada
Contact: Ms. Maggie Westhaver (Maggie@seva.ca)
Seva Foundation, Berkeley, USA
Contact: Dr. Suzanne Gilbert (suzgilbert@earthlink.net)