Gender Inequality in Eye Care in North Western Bangladesh

Abstract

Gender inequality in health care is a well-recognized fact particularly in developing countries; but the determinants of the inequality, both from the provider and consumer perspectives may vary substantially depending on demographic, socioeconomic and cultural background. Studies on gender inequalities are rare all over the world and it is virtually nonexistent in Bangladesh. Exploration of the extent of gender inequality and its determinants are vital for designing evidence based healthcare strategy in any community. In the present study, we aimed to investigate the determinants of gender inequality in eye care in a rural, semi-urban and urban population in north-western Bangladesh. This population was covered by a comprehensive eye care project (named as BADAS-ORBIS Eye care Project) operated by Thakurgaon Swasthoseba Hospital, and managed by the Diabetic Association of Bangladesh (Bangladesh Diabetic Somiti or BADAS, the parent organization of BIRDEM) supported by ORBIS, Dinajpur Govt. hospital and Panchagarh District Hospital. The study population, was selected by a randomization procedure from the total population covered by the project, surveyed by an interviewer administered pretested questionnaire to explore the gender-wise awareness regarding eye diseases as well as regarding the barriers to use of eye care services. In addition to the Socio-demographic and economic variables the cultural and psychological issues (like traveling alone to health centers, perceived value of surgery, lack of access to information and resources, fear of poor outcome, beliefs and superstitions) were given particular attention. Factors related to provider were also be assessed by the same method. Special focus was given to analyze the inequalities and determinants in terms of ‘sex’ as well as in terms of gender (which transforms the biological variable sex into the social variable ‘gender’). Data was analyzed by univariate analysis using Statistical Package for Social Sciences (SPSS). The data was expected to generate valuable suggestions regarding proper intervention to create gender balance in health care in general. Research shows that gender discrimination occurs more within the family than among healthcare providers or on the street. Girls are particularly vulnerable to it in the home of their in-laws. viii Awareness must be raised nationwide because this prejudice still takes place in families, particularly in the in-laws house, because of outdated superstitions or religious convictions. Religious speakers can free themselves from religious reforms through their speeches. The government could take the most significant step by making hospitals more welcoming to women and allocating a specific budget for women's healthcare.