A Kenyan doctor's perspective

Kenya is one of the best known developing countries in the world. At the moment the health sector is undergoing major reforms. These reforms aim at responding to the following constraints: decline in health sector expenditure, inefficient utilisation of resources, centralized decision making, inequitable management information systems, outdated health laws, inadequate management skills at the district level, worsening poverty levels, increasing burden of disease and rapid population growth.

Eye conditions fall among the top ten reasons for outpatient cases reported countrywide. Cataract is the leading cause of blindness and cataract blindness affects more women than men.

However recent blindness surveys in three districts in Kenya showed that the gap between blindness levels in males and females, as well as in cataract surgery coverage was much narrower than anticipated. For example in Nakuru the cataract surgery coverage was 78.3 % for males and 77.6 % for females.

Programmes that aim to empower women thus go a long way in closing the gap in access to eye care even in developing countries. These include programmes that allow women to access finance without reference to husbands and other males in their lives. In districts where such programmes exist, queues at eye units will tend to have as many women as men.