Gender issues in a cataract surgical population in South India

To investigate patterns and characteristics of men and women who used different cataract surgery payment streams in a South Indian hospital.

We randomly sampled patients with age-related cataract aged 40 years and over from three routine cataract surgical service streams: walk-in paying, walk-in subsidized and free camp. Presenting visual acuity (VA) and cataract surgical details were obtained from routine hospital records. Demographic and socioeconomic factors were collected from patient interviews. Multiple logistic regression was used to investigate factors associated with use of different streams with walk-in paying as the reference group.

There were 7076 eligible admissions (3742 women and 3334 men). Proportionately more women than men attended the walk-in subsidized (56%) or free camp sections (55%) compared to the walk-in paying stream (42%, odds ratio, OR, 1.40 95% confidence interval, CI, 1.25-1.57 and OR 1.33 95% CI 1.19-1.49, respectively). After adjustment for socioeconomic factors (illiteracy, not being in paid work), rural residence and poor presenting VA, OR for women compared to men for the walk-in subsided stream was 1.02, (95% CI 0.87-1.18) and for the free camp 0.94 (95% CI 0.80-1.11).

Our results indicate that women are underrepresented in the paying section, reflecting their poorer socioeconomic and educational statuses.