UBC Theses and Dissertations
Gender and blindness : evaluating gender specific community interventions in Upper Egypt Abdel Rahim, Ahmed Mousa
The prevalence of low vision and blindness is commonly high in developing countries. The majority (70%) of blindness burden is avoidable. Socioeconomic status and other community development aspects are highly affected by this burden. Cataract and Trachomatous Trichiasis are the major causes of avoidable blindness. Females are more affected by these diseases and less likely to use eye care services than males. Recently, the concept of multi-component intervention models was introduced to the research arena. There is a need for an integrated model that tackles different axes of blindness focusing on women. The current study adopts an integrated gender sensitive interventional model where community health education is its major component in addition other components including; screening and referral of eligible cases, breaking down barriers to eye care utilization, and capacity building of local eye care providers. In this study, we attempted to evaluate the effectiveness of the proposed mode through a community interventional trial. The intervention was applied to two villages in rural Upper Egypt where two other villages served as control. The proposed model managed to increase community knowledge, enhance attitudes and practice along with reducing most of its specific barriers to eye care service utilization. As a result, service utilization at the local hospitals increased by 20.6 %. Cataract and Trachomatous Trichiasis surgical uptakes also increased by 36.9% and 41.4% respectively. The local provider’s efficacy improved by 8.9 % increase in post operative visual functioning score. Patient satisfaction improved by 16.6% among cataract patients and by 11.1% among trichiasis patients. Selection of local provider as the first choice increased by 31.1%. Consequently, the prevalence of cataract reduced by 16.3% (18.4% female specific), and trichiasis prevalence by 5.7 % (8.2% female specific). The overall prevalence of low vision and blindness decreased by 13.3 % (14.1% female specific) and 7.2% (9% female specific) respectively. Integrated community based interventions that tackle different aspects of the prevention of blindness are highly effective. Gender sensitive community health education should be the major component of such models. These models could be modified and tailored to address specific needs of target communities.
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