A study on challenges in assessing free cataract surgery services in India: a gender perspective
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20251730Keywords:
Cataract surgery, Gender disparities, Accessibility, Healthcare barriers, Blindness in IndiaAbstract
Background: Cataracts are the leading cause of blindness worldwide, accounting for 51% of cases as per World Health Organization (WHO). Despite cataract surgery being cost-effective, accessibility remains a challenge, particularly in low-income settings. Barriers include affordability, geographic constraints, and cultural acceptability. Gender disparities further limit access, as women—who form a larger proportion of visually impaired individuals—are less likely to receive surgery due to social and economic factors. This study examines cataract surgery accessibility through a gender perspective, identifying systemic, financial, and cultural barriers.
Methods: A multicentre, retrospective study was conducted across 15 diverse locations in India, covering urban, semi-urban, and rural regions. Patient records of individuals who underwent free cataract surgeries were analyzed. Data were collected via structured telephonic interviews, including demographics, socioeconomic status, and perceived barriers. A total of 1,361 patients participated (53% female, 47% male). Statistical analyses, including Chi-square tests, assessed gender-based disparities.
Results: Most respondents (60.18%) independently attended eye screening camps, with males (73.57%) being more self-driven than females (48.04%). Family, especially sons and spouses, influenced women’s decisions. Mobility challenges, financial dependency, and sociocultural norms limited women’s access. While 76.05% were confident about future hospital visits, 14.62% cited transport, financial, or health concerns.
Conclusions: Gender-based barriers in cataract surgery access must be addressed through community outreach, financial support, and culturally sensitive education campaigns. Targeted interventions are essential to ensuring equitable eye care, reducing preventable blindness, and improving women’s healthcare access and participation. Future research should focus on region-specific policies promoting gender-inclusive eye care.
Metrics
References
World Health Organization. World report on vision. 2021. Available at: https://www.who.int. Accessed on 18 March 2025.
Resnikoff S, Lansingh VC, Wilson D. Global initiatives to eliminate avoidable blindness and improve cataract surgery outcomes. Comm Eye Health J. 2020;33(109):10-3.
Lewallen S, Courtright P. Gender and use of cataract surgical services in developing countries. Bull World Health Organ. 2002;80(4):300-3.
Ramke J, Zwi AB, Lee AC, Blignault I, Gilbert CE. Inequality in cataract blindness and services: moving beyond unidimensional analyses of social position. Br J Ophthalmol. 2017;101(4):395-400. DOI: https://doi.org/10.1136/bjophthalmol-2016-309691
Kuper H, Polack S, Eusebio C. A systematic review of barriers to cataract surgery in low- and middle-income countries. Ophthalmic Epidemiol. 2008;15(3):135-43.
Courtright P, Lewallen S. Reducing gender inequity in vision loss: A global perspective. Acta Ophthalmologica. 2009;87(6):584-5.
Khanna RC, Marmamula S, Rao GN. Gender and blindness: Evidence from the Andhra Pradesh eye disease study. Indian J Ophthalmol. 2012;60(5):408-14.
Gupta A, Verma R, Shah S. Religious affiliation and healthcare decisions: A cross-cultural perspective. Int J Cultural Stud Med. 2021;18(4):67-85.
Ahmed A, Khan F. The Impact of Religion on Health Service Utilization in Diverse Societies. J Public Health. 2017;9(4):345-58.
Desai S, Joshi S. Marital Status and Healthcare Behavior: A Comparative Study. Health Sociol Rev. 2016;25(2):178-90.
Gupta P, Verma R, Sharma K. Gender Disparities in Eye Health. Indian J Ophthalmol. 2019;67(3):271-7.
Patel N, Singh A, Reddy S. Education and Health Literacy: Bridging Gaps in Rural Populations. Global Health Action. 2020;13(1):123-39.
Reddy S, Verma R. Community Outreach Programs for Eye Health. Vision Res. 2017;55:45-52.
Sharma K, Patel A, Mehta N. Challenges in Eye Healthcare Access in Rural India. Optometry Vision Sci. 2018;95(6):563-70.
Singh A, Gupta P, Joshi S. Cataracts and Refractive Errors: Leading Causes of Vision Impairment. Indian J Comm Med. 2018;43(2):143-50.
Verma R, Patel N, Reddy S. Occupational Hazards and Eye Health. Occup Health Rev. 2019;11(1):67-74.