Abstract
Purpose To determine whether the female gender is a barrier for the access to cataract surgery services in South Asia in the last two decades. Methods Eligible cross-sectional studies were identified via computer searches and reviewing the reference lists of the obtained articles. The cataract surgical coverage (CSC) by sex based on person and eyes at visual acuity <3/60 and 6/18 is extracted. Pooled odds ratios (ORs) for males receiving cataract surgery in comparison with females were calculated by a random effect model. Results Sixteen studies with 135972 subjects were included in the final analysis. The pooled ORs of CSC by sex on a person basis at visual acuity <3/60 and at visual acuity <6/18 were 1.46 (95% CI: 1.23–1.75) and 1.14 (95% CI: 1.05–1.24), respectively. For CSC on a per-eye basis at visual acuity <3/60, the associations were statistically significant, with a pooled OR of 1.40 (95% CI: 1.16–1.70). The values of population attributable risk percentage at a per-person and per-eye basis at visual acuity <3/60 were 6.28% and 7.48%, respectively. Subgroup analyses by design and location types attained similar results as the primary analyses. There was no evidence of publication bias. Conclusions The female gender remains a significant barrier for the access to cataract surgery in South Asia. Visual impairment, including blindness, from unoperated cataract, could be reduced by approximately 6.28% with the elimination of gender disparities to access. More efforts are needed to increase eye care service utilization by female population.
Highlights
In 2010, it was estimated that there were 39 million people blind globally, with 51% being attributed to cataract [1]
Our results demonstrated that the female gender remains a significant barrier to the access of cataract surgery in South Asia, with males having 1.46 odds of receiving cataract surgery compared to females per-person at blind VA
The female gender remains a significant barrier to the access of cataract surgery in South Asia
Summary
In 2010, it was estimated that there were 39 million people blind globally, with 51% being attributed to cataract [1]. South Asia, which accounts for 24.6% of the world’s population, has undergone fundamental transitions in society and economic development over the past two decades. This region has achieved significant progress in blindness prevention, it still accounts for 32.7% of the world’s blind population in 2010 [2]. The expansion rate of the blinded population was 4 times higher in females than that in males (16.1% versus 3.7%) from 1990 to 2010, which poses significant public health concerns [2, 3]. Cataract remains the leading cause of blindness, which accounts for 41.7% blindness in this region in 2010 [3]
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