Gender norms, roles and relations, and gender inequality and inequity affect people’s health all around the world. India’s National Health Policy – 2017 focuses on the health of the poor and dedicates a section to the health of women and related socioeconomic and cultural issues.1 This policy endorses the need to expand the primary health care infrastructure to increase women’s access to care. The policy also recognizes a need to review staffing in the public health service, so that it may become more responsive to the specific needs of women.
In tune with the National Health Policy – 2017, Mission for Vision (MFV) runs several community eye health initiatives in partnership with eye health NGOs that guarantee women’s access to primary eye care (PEC) services and enable greater participation of women in the allied ophthalmic workforce.2
On the occasion of World Health Day, we discuss two such novel strategies that uphold gender balance and narrow down the gender divide.
Mission Jyot is a primary eye care intervention, wherein vision centers (VC) are established strategically to maximise access to underserved communities by offering services at nominal rates. Under this, a total of 71 VCs were established in partnership with leading eye care hospitals in 12 states of India, as of December 2021.3
- The novel all-women vision centers
In order to improve ‘access’ to PEC services, specifically for women and girls, in remote, tribal communities in the Raigad district of Maharashtra state, MFV has established two novel VCs in the district that are manned entirely by women staff. Since their inception in 2019, the proportion of women and girls seeking care has steadily improved and currently stands at 60%. Overall, the uptake of screening services, identification of refractive errors, and cataract cases were significantly higher amongst women clients at these two VCs as compared to the standard VCs in the state.4
- Human resources and staff structure at vision centers
In order to enable wider access to PEC services, specifically to include more women and girls, in about 80% of VC established by MFV we employed women as community health workers (CHW). The CHWs undertake door-to-door screenings in the communities, focusing on vulnerable populations like children, women, and the elderly. Additionally, about 30% of all optometrists and 75% of support staff (data entry, field-supervisors) employed at the VCs were also women. This staff composition and structuring has enabled us to reach out to more women and girls. The latest data as of February 2022 indicates that over 50% of all those availing PEC services at VCs were female subjects. The proportion of women receiving spectacles (53%) and those referred and operated for cataracts (52%) was higher as compared to men.
Mission Saksham aims to train young people from disadvantaged backgrounds as allied ophthalmic personnel (AOP). The first phase of this initiative aspires to train 2,000 candidates by 2025.5 As part of this, supported by the Wen Giving foundation, substantial scholarships are awarded to young persons from economically vulnerable and marginalised communities to train them as AOP.
- Preferential opportunities for girl students
Mission Saksham particularly encourages girls to apply for these scholarships. Our experience reveals that boys are generally given preference over girls for education or health in disadvantaged communities. A recent report by International Center for Research on Women (ICRW) in India revealed that sons are preferred while daughters are neglected when it comes to health, nutrition, and education.6 To address this disparity, girls were given preferential opportunities and were encouraged to apply for scholarships, so that they become economically independent. As of end of February 2022, a total of 363 students were enrolled in various AOP courses, of which 85.4% were girls. Out of the students who have completed the course (n=165), a total of 142 (86%) students were successfully placed in various tertiary eye hospitals and VCs, of which 66% were girls.
- Community impact and change agents
Upon completion of the course and being successfully placed in jobs, these AOPs act as the agents of change in their respective communities. These AOPs are breaking traditional gender-based stereotypes concerning education and financial independence of girls. Discussion with these trained AOPs after their posting revealed that their success had a positive multiplier effect on their communities, in terms of increased awareness, increased uptake of AOP courses by girl candidates, and improved standard and quality of living for their families.
The novel strategies discussed above have narrowed down the gender divide and can certainly be scaled-up and replicated in other geographies in order to achieve sustainable development goal #5 (SGD-5), which aims to achieve gender equality. MFV would continue to focus its attention on the gender aspects in all its PEC initiatives.
- Ministry of Health and Family Welfare. National Health Policy 2017. Ministry of Health and Family Welfare, Government of India, New Delhi, India. 2017. Available from: https://www.nhp.gov.in/nhpfiles/national_health_policy_2017.pdf [Last accessed: 21 March 2022].
- Mission for Vision. Programmes. Mission for Vision, Mumbai, India. Available from: http://www.missionforvision.org.in/programmes [Last accessed: 21 March 2022].
- Mission for Vision. Mission Jyot. Mission for Vision, Mumbai. Available from: http://www.missionforvision.org.in/mission-jyot [Last accessed: 21 March 2022].
- Kumar SGP, Jadhav A, Kurian E. Women healthcare providers & uptake of primary eye care services: A healthcare intervention. The International Agency for the Prevention of Blindness. 2021. Available from: https://www.iapb.org/blog/women-healthcare-providers-uptake-of-primary-eye-care-services-a-healthcare-intervention/ [Last accessed: 21 March 2022].
- Patel S, Kumar SGP, Vishwakarma P, Kurian E. Training allied ophthalmic personnel to meet India’s eye care needs. Comm Eye Health. 2020; 33(110)-S13.
- Pande R, Malhotra A. Son preference and daughter neglect in India: What happens to living girls? International Center for Research on Women. New Delhi, India. 2006. Available from: https://unfpa.org/sites/default/files/resource-pdf/UNFPA_Publication-39764.pdf [Last accessed: 21 March 2022].
Photo Credit: Shrikant Ayyangar, Mission for Vision
Focus on Gender Equity, throughout the year, shares knowledge, inspiration and ideas from some of the world’s most innovative experts and inserts eye health and Gender Equality onto the agenda of the world’s most pressing development issues and is supported by Santen.