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      A qualitative study on gender barriers to eye care access in Cambodia

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          Abstract

          Background

          The Fred Hollows Foundation (FHF) Cambodia recently partnered with the Ministry of Women’s Affairs (MoWA) and National Program for Eye Health (NPEH, part of the Ministry of Health) to establish the Gender Equality in Eye Health Project. As part of this project, a qualitative study was carried out to identify barriers affecting women’s access to eye health in Cambodia.

          Methods

          A cross-sectional qualitative study was conducted in four provinces in both urban and rural locations between May and June 2015. Purposive sampling was used to identify respondents from a range of age groups, geographical locations, and experiences to explore different perceptions regarding access barriers to eye health care. Thirteen women experiencing eye problems (age range 45–84 years; mean age 63 years) and 25 eye health professionals took part in in-depth interviews. Eleven focus groups discussions were held with 69 participants (50 women, 19 married men) to capture the views and experiences of both younger and older women, as well as household decision makers’ perspectives.

          Results

          Gender-based differences in decision-making, access and control over resources and women’s social status all contributed to impeding women’s access to eye health services. Women relied predominantly on informal sources of information about health, and these channels might be utilised to address barriers to information and access. Disparities in perceived costs of eye health treatment were evident between eye healthcare providers and users: costs were not perceived as a barrier by service providers due to health financing support for poor patients, however, many users were not aware of the availability of the scheme.

          Conclusion

          Demand-side and supply-side elements interact to reduce women’s ability to seek eye treatment.

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          Most cited references5

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          Gender and blindness: a meta-analysis of population-based prevalence surveys

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            Gender and use of cataract surgical services in developing countries.

            To determine, from the existing literature, cataract surgical coverage rates by sex and the proportion of cataract blindness that could be eliminated if women and men had equal access to cataract surgical services. Methodologically sound population-based cataract surveys from developing countries were identified through a literature search. Cataract surgical coverage rates were extracted from the surveys and rates for women were compared to those for men. Peto odds ratios were calculated for each survey and a meta-analysis of the surveys was performed. From a literature review and meta-analysis of cataract surveys in developing countries, we found that the cataract surgical coverage rate was 1.2-1.7 times higher for males than for females. For females, the odds ratio of having surgery, compared to males, was 0.67 (95% confidence interval (CI): 0.60- 0.74). Despite their lower coverage rate, females accounted for approximately 63% of all cataract cases in the study populations, and if they received surgery at the same rates as males, the prevalence of cataract blindness would be reduced by a median of 12.5% (range 4-21%). Closing the gender gap could thus significantly decrease the prevalence of cataract blindness, and gender-sensitive intervention programmes are needed to improve cataract surgical coverage among females.
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              The Impact of Knowledge and Attitudes on Access to Eye-Care Services in Cambodia.

              To investigate how knowledge and attitudes influence the access to eye-care services in Takeo Province, Cambodia.
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                Author and article information

                Contributors
                +61 418 175 311 , camille.neyhouser@gmail.com
                ingridquinn@gmail.com
                thillgrove@hollows.org
                rchan@hollows.org
                cchhorvann@niph.org.kh
                speou@hollows.org
                psambath@hollows.org
                Journal
                BMC Ophthalmol
                BMC Ophthalmol
                BMC Ophthalmology
                BioMed Central (London )
                1471-2415
                29 August 2018
                29 August 2018
                2018
                : 18
                : 217
                Affiliations
                [1 ]The Fred Hollows Foundation, Level 2, 61 Dunning Avenue, Rosebery, Sydney, NSW 2018 Australia
                [2 ]ISNI 0000 0004 4902 0432, GRID grid.1005.4, School of Public Health and Community Medicine, Faculty of Medicine, University of New South Wales, ; Kensington, NSW 2052 Australia
                [3 ]Siem Reap, Cambodia
                [4 ]Phnom Penh, Cambodia
                [5 ]The Fred Hollows Foundation Cambodia, Phnom Penh, 12301 Cambodia
                Author information
                http://orcid.org/0000-0001-7857-1960
                Article
                890
                10.1186/s12886-018-0890-3
                6116508
                30157788
                39a93a50-ba1e-4f18-b335-d067fbd6f196
                © The Author(s). 2018

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 29 January 2018
                : 17 August 2018
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2018

                Ophthalmology & Optometry
                barriers,cambodia,eye care,gender role
                Ophthalmology & Optometry
                barriers, cambodia, eye care, gender role

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