Reaching the underserved: Acknowledging the importance of informal markets

How local entrepreneurs can drive equitable access to vision care  

In many low- and middle-income countries, formal optical channels are limited or non-existent in rural and underserved areas. Informal markets, comprised of small-scale vendors, travelling merchants, and local micro-entrepreneurs, are often the only distribution channel available. Rather than viewing them as a liability, governments can embrace their reach to deliver affordable glasses at scale.  

A critical access point  

According to the International Labour Organization, about 2 billion workers spend at least part of their time in the informal sector. In some countries, the informal sector accounts for up to 80% of glasses distribution. These channels are particularly important for reaching groups often missed by formal systems.  

Unlocking their potential  

Transformative change must include everyone. Rather than excluding informal actors, governments can develop strategies to support and regulate their involvement in the broader eye care system. This could include offering basic training in spectacle fitting, providing access to low-cost, quality-assured products, and linking informal providers to formal referral systems for cases requiring medical attention.  

Enabling conditions for growth  

Informal vendors and entrepreneurs often operate without financial services, making it difficult to invest in quality improvement and operate within regulatory frameworks. Governments can encourage formalisation by simplifying registration burdens, easing taxation, and ensuring informal workers and small businesses can access mobile financial services.  

Engagement will be key 

Involving these providers in reform does not seek to undermine existing regulatory frameworks, but aims to maximize the scale of the referral system. Supporting the informal sector in this way acknowledges the economic realities of underserved populations. As part of sustainable health system reform, governments should engage ALL relevant stakeholders needed to achieve our 2030 (and onward) targets for eye care. 

Sources, Deloitte (2018): Eyewear market in India, Frontier Economics (2024) Glasses for all: Improving supply to the poorest, ILO (2018) Women and men in the informal economy: A statistical picture