Quantifying inequality and understanding inequity
In order to address inequity, we must first quantify the nature and extent of inequality that exists in a particular setting. This includes gender, which is an important axis along which inequity in eye health exists. We also recognise the importance of assessing inequality along other PROGRESS axes such as socioeconomic status, rurality and social support, and how they intersect with each other. For example, we have demonstrated cumulative disadvantage in cataract blindness and service outcomes, with the likelihood of poor outcomes increasing with each additional axis along which disadvantage is experienced. We have also shown that in diverse settings rural women without a spouse experience a disproportionate level of blindness from cataract due to lower access to good quality services.
Ongoing studies
- Gender and eye health: overview of systematic reviews.
Objective: To summarise the nature and extent of the evidence in published systematic reviews on i) gender inequality in eye health; and/or ii) interventions to reduce gender inequality.
Protocol: Ramke J, Mwangi N, Burnett A, Black J, Kyari F, Mowatt L, Salomao S, Yasmin S, Evans JR. https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=139017
Publications:
- Ramke J, Kyari F, Mwangi N, Piyasena MMNP, Murthy GVS, Gilbert CE. Cataract services are leaving widows behind: examples from national cross-sectional surveys in Nigeria and Sri Lanka. Int J Environ Res Public Health 2019;16(20):3854. https://www.mdpi.com/1660-4601/16/20/3854
- Ramke J, Gilbert CE. Universal Eye Health: Are we getting closer? Lancet Global Health 2017;5(9):e843–e44. https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(17)30302-9/fulltext
- Poverty and blindness in Pakistan: results from the Pakistan national blindness and visual impairment survey. https://www.bmj.com/content/336/7634/29
- Poverty and Blindness in Nigeria: Results from the National Survey of Blindness and Visual Impairment. https://doi.org/10.3109/09286586.2015.1077259