Gender equity in SiB Child Eye Health project, China

Published: 20.12.2017

Gender Equity in SiB V Shanxi CHEER Project

As of October 2017, there is about 2% increase in cumulative surgical uptake for girls after nine months’ effort, although there are still fewer girls than boys who have received surgery. Apart from surgical service, there is also gender discrepancy in other eye care services such as low vision service and even optical service which can be seen in the table below. Most of the numbers referred in school screening are due to vision problem, which means that more school girls need to be referred to local hospital because of vision/refractive error. Therefore, the equal ratio of refraction and spectacle distribution does not mean equal number of girls and boys received optical service. The ratio is more equal for free spectacles when considering the number to be referred. The number of girls is nearly equal in school screening.

	Total	Boys	Girls	% Girls
# school screening	1,215,637	605,022	601,324	49%
# need to be referred	289,930	136,580	152,538	53%
# cumulative surgery	6,972	3,949	3,023	43%
Cataract surgery	589	331	258	44%
Other major surgery	4,693	2,632	2,061	44%
Other minor surgery	1,690	986	704	42%
# subsidized surgery	581	316	265	46%
# refraction	296,220	149,307	146,913	50%
# spectacles distribution	196,404	97,953	98,451	50%
# free spectacles	12,662	5,761	6,901	55%
# low vision service	5,351	2,945	2,406	45%

In early 2017, we discussed with hospitals at different levels about the gender discrepancy in surgeries performed. The reasons given by eye care professionals for less girls receiving operations than boys included:

The ratio of boys to girls in most part of Shanxi province is 107:100 so no real discrimination is evident in terms of surgical uptake.
The prevalence of eye injury is higher among boys because in general boys are much more active and fond of sports.
There are a small number of families that do not treat girls equally to boys when there is limited financial resource in the family. For example, the boy with congenital cataract may receive surgical treatment earlier than his sister with the same problem.

Strategies on addressing the gender issue given by hospitals and action taken in the project are as following:

Improve referral from screenings by strengthening communication and follow up with teachers and families.
Tell and share the contact number of the successful cases.
Conduct public events and more favorable eye care services (e.g. surgery, optical service) to girls on Children’s Day, National Sight Day and World Sight Day.
Strengthen school eye health education to prevention on injury.
Continue to raise parents’ awareness about eye problems and favorable polices.
Regularly analyze eye care service data with hospitals and discussing findings and solutions.
Provide subsidized surgery to more girls.

Above actions will be continuously taken to narrow the gender difference.