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Of the 1.1 billion people with vision loss, women and girls account for 55% – and most of them live in low and middle-income countries. Currently, there are 23.9 million women or girls in the world who are blind and 163 million who have vision impairment.
China has the highest burden of avoidable blindness in the world, accounting for 20% of the global total. Up to 80% of China’s blind population live in rural areas where the availability and access to eye health services are low. Women are also more likely to suffer and are less likely to access eye care services.
While overall economic and educational development in China has improved women’s social status dramatically, inequality still exists in rural areas where there is a lack of awareness about gender inequities in accessing eye health.
There is increased concern about the eye health of females in rural minority areas in Guangxi. In rural Guangxi, there are about 527,000 people with eye diseases, of which about 55% are women and girls. Women living in rural areas usually have far fewer opportunities to access eye health information and eye care services.
Understanding the barriers
Women are 1.3 times more likely to be blind than men due to various social, cultural and economic barriers. Gender-sensitive decision-making within households mean that women lack autonomy over their diagnosis and treatment. Women often need to prioritize household chores and the well-being of their family members over eye care. Women are also more likely to be kept at home as primary caregivers and unable to share child-rearing responsibilities with others in the household, which can prevent them from travelling for treatment.
Women with blindness or visual impairment face high costs and limited access to treatment, as they generally do not have a steady income and do not have the financial independence to seek care. Due to gender imbalance in many communities, men control the family finances, and their medical needs are prioritised over women.
In the eye health sector, gender inequity is an issue that we can no longer turn a blind eye to. Vision impairment and blindness negatively affects women’s quality of life, employability, earning power, ability to rejoin the workforce, labour productivity, educational attainment, and their capacity to participate actively in society.
Vision impairment and blindness have far-reaching macroeconomic implications, not just for the women affected, but also for their families and communities, and hampers progress towards many of the Sustainable Development Goals, such as gender equality, decent work and economic growth.
Change is required to achieve equity, inclusion for women and girls with blindness and vision impairment at local, national, and international levels. International eye health organisation The Fred Hollows Foundation has been a key global advocate for reducing gender disparity in blindness by placing women at the center of programming, service delivery, partnerships and training. When we empower women with sight, we transform lives.
Promoting women’s eye health in Guangxi, China
In 2019, The Fred Hollows Foundation in China partnered with the Provincial Women’s Federation, Health Commission, Education Department and Disabled Persons’ Federation on the Guangxi Comprehensive Rural Eye Care Project. By adopting a gender equity mainstreaming approach, this project aimed to strengthen gender equity in eye health in rural minority areas in Guangxi and to increase awareness and availability of eye health care for women and girls.
Since the implementation of the project, more than 110,000 people have been screened and 971 key female village leaders and 1,129 village doctors have been trained in the promotion of women’s eye health. At the end of the training, participants showed an increase in their understanding of gender and eye health and felt more confident to promote the importance of women’s eye health.
While COVID posed many challenges, the project has been a success and was praised by the local county and provincial governments, leading to the possibility of the project being replicated in other regions. Based on the project’s success in Guangxi, The Foundation plans to expand its reach to deliver the program to five provinces in central and western China where there are greater unmet needs.
Investing in China’s eye health, specifically reducing gender disparity in eye care, will provide positive benefits for women, their families and communities at large, by improving labour productivity, workforce participation, earning power, education attainment and economic growth.
As Dr Zongfa Wang from The Foundation’s partner hospital in Yunnan Province said: “A cured patient helps the whole family, because it means someone – usually a young woman – doesn’t have to look after them anymore and is free to return to school or work. For people in their 40s it means they can get a job and improve their family’s finances.
Investing in vision is cost-effective and the benefits of eliminating avoidable blindness and visual impairment far exceed the investment required, as shown by a study conducted by PricewaterhouseCoopers (PwC) for The Fred Hollows Foundation. The study found the cumulative benefits achieved from eliminating avoidable blindness in Yunnan Province, China over 8 years amounted to $4.7 billion in total.
Ending gendered inequity in eye health will not only yield quantifiable financial benefits, but will also strengthen national health systems, national economies, and communities. The international development community must come together to close the gender gap in blindness around the world.