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Three ways to make eye care accessible for women in The Pacific, and why we must
Despite significant developments in the delivery of universal healthcare, women in developing countries still struggle to access eye care services. This is very true of the Pacific communities The Fred Hollows Foundation NZ serves, and those I’ve spent over half my career working within.
Few eye care specialists would have been surprised when The Lancet Global Health Commission on Global Eye Health last month reported, that for every 100 men experiencing blindness worldwide, there are 108 women affected. As in many other cultures, women form the backbone of Pacific communities. They are the managers of households and guardians of children. If we are to see sustainable impacts from development activity in the Pacific, we must do better at getting eye care services to women.
Improving access to eyecare for Pacific women in the region requires a shift in the way we view the delivery and measurement of eye care services. I’ve highlighted three actions that, if taken universally, will go some way to increasing access to eye care for women in The Pacific.
The WHO World Report on Vision suggests gender inequity in the use of eye care services could be explained by factors such as greater challenges for women in travelling to health services due to limited financial decision-making power, and minimal experience in travelling outside their community. This is true for many Pacific women living in rural communities who don’t run a nine-to-five, Monday to Friday schedule. Pacific women’s schedules often revolve around the needs of children and other members of the household and aren’t planned or predictable.
To reach these women, eyecare delivery must decentralise. We must move away from cities and hospitals and go to the communities where the need is greater. The Fred Hollows Foundation NZ supports an average of 230 outreaches per year with significant results. Furthermore, by bundling eye screens or treatment with other outreach services such as cervical screening or childhood immunisations, time-poor women can access multiple services with one visit. Barriers to treatment for women are well-documented, so let’s take action to remove them.
Many of us chose a career path to emulate someone we looked up to. For me, it was my mother who was a relentless trailblazer in the development of Pacific programmes and initiatives in the Pacific Region and New Zealand during the 1970s. I have seen how female eye doctors and nurses inspire young females to follow in their footsteps, and the whole community benefits.
As at December 2020, 22 female eye doctors and 179 female eye nurses had graduated from training programmes supported by The Fred Hollows Foundation NZ. We continue to hold ourselves accountable to target and support Pacific women into these roles, but in partnership with local health and education leaders and the wider community, we can do more. To ingrain and prioritise eye healthcare in Pacific communities, we must target and support more female eye doctors and nurses. This requires all those working in the medical and education sectors in The Pacific to join forces to encourage more school-age girls into STEM subjects and provide clear career paths and possibilities for women.
While it is heartening to see the impacts of, and solutions to, blindness measured – one voice is notably absent. Engulfed by Australia and New Zealand as part of Oceania, research generally overlooks the complexities of the Pacific. The paucity of eye health data in the Pacific Region likely contributes to a lack of understanding of the burden of eye health in the region and therefore poor reflection in global research. However, Pacific nations share characteristics which set them apart from those in Asia, the Americas, Africa, Europe, and critically, Australia and New Zealand. A Pacific voice is not heard when articulating the problem, and Pacific complexities and challenges are not considered when formulating solutions. That must change.
If we are to reduce the burden of avoidable blindness in the Pacific, we must adapt how we provide eye care services to women in the Pacific. A contextually relevant approach is necessary, which requires us to work alongside our local partners to improve and integrate the delivery and measurement of eye care services. Only then can we best support Pacific Ministries and governments to deliver meaningful and sustainable outcomes for the whole community.