Reaching women in Egypt: a success story

suffer from low vision or blindness from avoidable causes.1–3 This is, in large part, because women are not using eye care services as frequently as men, especially in rural areas.4–5 A 2002 community-based survey of 4,500 people in Al Minya Governorate, Upper Egypt showed that the prevalence of cataract in women was double that in men and that trachomatous trichiasis was four times as prevalent in women as in men.3 Egypt has a large number of eye care providers, even in rural and suburban areas, but a very low uptake of eye care services. On the provider side, this is due to poor clinical outcomes and poor interaction with patients, both of which contribute to fear of surgery. On the patient side, low uptake is due to lack of family support, stigmatisation, and the fact that older persons (who are more likely to be visually impaired or blind) are less able to influence decisions within households. Many also believe that they are too old for surgery. As a result, few patients actually seek eye care. From formative research conducted in Al Minya, we know that women face particular difficulties in accessing services: