• Health service delivery

Health service delivery

Surgical intervention is necessary if children with cataract are to regain their sight. In many low- and middle-income countries, cataract is the leading cause of avoidable blindness among children. This article in Community Eye Health Journal considers the gender dimensions of surgery and the background to the situation in Tanzania where many children are not brought for surgery in a timely fashion and follow up is often poor. The authors show how girls have a significantly lower rate of surgery with only half as many girls receiving treatment as boys. In addition girls tended to be bought for surgery much later than boys and those who did receive surgery were less likely than boys to be brought for the appropriate two-week follow-up visit.

The authors highlight how in poor or struggling communities, sons are often seen as a source of income and financial security for parents when they get older, whereas girls are seen as a financial burden. This can mean that boys will be more likely than girls to be taken to a clinic for health care. Analysis showed that women’s level of education, their socioeconomic status, and the decision-making power they had within their household and their community all played a major role in determining whether and when their children would receive cataract surgery and whether they would be taken for follow-up visits. A number of ways forward are discussed including mass media efforts which may provide the first opportunity for rural villagers to learn about the need for early referral of young children with vision loss.

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