In 2001, the road to eliminating avoidable blindness was dramatically altered by the Seva Canada-sponsored study which found that 2/3 of the world’s blind are women. While women are not more likely to become blind than men, they are far less likely to access the care they need due to the social, cultural and economic barriers they face. Seva’s leadership in the global initiative that followed made the eye care community aware that by addressing the specific barriers faced by women, avoidable blindness could be dramatically reduced.

Malagasy woman and her daughter behind her smiling

Malagasy Key Informant with her daughter © Ellen Crystal

Today, almost all Seva-supported programs serve an equal or greater number of women than men. This is because we began disaggregating their data by sex, to see and monitor where inequities exist, and began implementing gender-specific strategies; namely moving services closer to home, providing gender sensitivity training and education to staff at all levels, engaging with female community leaders and engaging with financial decision makers in households.

While gender equity has improved for adults, girls remain 2 to 3 times less likely to access and receive care than boys. Therefore, the strategies that worked for women have proven inadequate for girls, who face a double layer of inequality – the same inequities as their mothers and the added barrier of being a child, unable to advocate for themselves.

Malagasy girl with baby on her back smiling at camera

Malagasy girl © Deanne Berman

A 2015 Seva-sponsored study of 5 major child eye care facilities in Asia and Africa concluded that most of the gender inequity for children occurs at the community level where extraordinary efforts are needed to convince families to bring their girls in for treatment. Oftentimes, persistent effort by a single eye care program person – like an ophthalmologist traveling a full day to convince a family in person - is necessary in order for girls to get the care they need.

Malagasy girl getting tested for refractive errors

Malagasy girl having vision assessed for refractive error © Ellen Crystal

Most eye care programs do not have sufficient community-based strategies or ophthalmic personnel to make these extraordinary efforts for girls. Improvement will likely be slow as programs learn from their success stories and invest in new gender equity programs and personnel. Our role in the years to come is to learn about and disseminate knowledge of the successful strategies starting with individual case study reports. We will advocate for girls just as we did for women - raising awareness in the global eye care community and helping eye hospitals and clinics understand the need, importance and enduring value of giving girls the power of sight and an enriched future.

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