Beyond 20/20: Shedding Light on Gender Inequity in Eye Health Access in India

It was just another day of my regular field visit, where I crossed three very cheerful women in a quaint little village in Rajasthan. They saw me standing at a crossroads in the village, looking for a patient who recently underwent cataract surgery, and I decided to visit him. The juxtaposition of a confused-looking city person like me in the backdrop of a village was intriguing to these women. It would have made them walk up to me to enquire about my purpose for stepping into the town. They did not hold themselves back from slapping my back after I greeted them as if I was an old friend. I informed them about the purpose of my visit, and upon hearing about eye health, they all started telling me about their eye health-related issues. I asked them when was the last time they had their eyes tested. They laughed aloud and said they had never had their general health checked up. Only when ASHA (Accredited Social Health Activist) behen visits their homes do they somehow spare time, but they can never follow through and visit the nearby primary health centre. When they are ill, the family’s patriarchs get their medicines from a local person or manage their illness by praying to god, keeping fast or using home remedies. I spent some time with them and explained the relevance of keeping their eyes healthy and getting them checked regularly at eye health camps organised in their villages or government health centres. Perhaps they realised it is essential to keep their eyes healthy because I observed them listening to me keenly. With the promise of meeting these women while leaving the village, I bid them adieu and wended through the narrow lanes to the patient’s house I planned to visit.

I spent a long time with the patient, who was quite satisfied with the outcome of the surgery and could not stop singing praises of the government district hospital. Watching a person get his eyesight back was a happy sight. I could not help but notice the man’s wife who was struggling with some work in the kitchen area and appeared a bit sick, and upon enquiring, I learnt that she had been down with poor health for years and managed it with home remedies. Even she did not get her eyes checked up yet in any camp or health centre. Whenever there are camps, the men of the house visit for checkups leaving behind the women who are extremely busy with household chores. Sometimes they do get volunteers who encourage them for health checkups, but the patient’s wife cannot leave the house. She stated – “Dikkat hai ghar se nikalna itni der, khana kaun banayega, bachhe kaun dekhega” (It is difficult to leave the house, who will cook food and who will take care of the children?).

My tête-à-tête with the women I met earlier and the woman I met later when I visited the cataract patient was a testament to the fact that women are the most unreached section of society regarding addressing health needs.

Multiple studies state that the prevalence of preventable blindness caused due to cataracts is much higher in women than men. World over, almost two-thirds of people blind from cataracts are women, yet cataract surgical coverage is higher in men. Gender disparity continues to be a persistent issue in various aspects of society, and one area where it is particularly evident is in eye health. Deep-rooted sociocultural norms and practices in India often result in disparities in healthcare access for women.

In many cases, women prioritise the health of their family members over their own, leading to neglect of their well-being, including eye health. Traditional gender roles assign women the primary responsibility of household chores and caregiving. These roles can hinder their ability to prioritise their health and seek medical attention when needed, including eye care. More awareness about eye health, particularly among women in rural areas, is required. Lack of knowledge about preventive measures, symptoms of eye diseases, and available treatment options prevents women from seeking timely care.

In India, women face financial constraints due to lower socioeconomic status and limited employment opportunities. Women primarily depend on the house’s male members to take them for eye health checkups, especially in cases of older women and pregnant women. Because most men rely on daily wages, it is difficult for them to forgo their salary for the day. The fear of being harassed and insecurities cease the urge to visit centres and distantly located places. Consequently, most women are less likely to seek eye care services or delay treatment until the condition worsens.

To address the gender disparities in eye health, one of the crucial steps is raising awareness about eye health through community-based programs, campaigns, and educational initiatives that can empower women to take charge of their eye health. The male members of families must be made the focal point of sensitisation towards the eye health needs of women. The sensitisation programmes must include the relevance of good eye health in women and how it impacts the lives of men, too, if the eye health needs are unmet. These efforts should focus on educating women about common eye diseases, the importance of regular eye check-ups, and available treatment options. Expanding the reach of eye care services, particularly in rural areas, is essential. Initiatives like mobile eye clinics and door-to-door primary eye check-ups can be crucial in reaching remote areas where access to healthcare is limited. Addressing gender disparities in eye health requires a multisectoral approach involving collaboration among healthcare providers, government agencies, non-profit organisations, and community leaders.

By addressing the underlying factors contributing to gender inequality in eye health, India can make significant strides in ensuring equal eye care opportunities for all its citizens, regardless of gender. Ultimately, a society where women have equal access to eye health services will improve well-being and productivity, benefiting individuals and the nation.