Background:In the South Asian sub-continent, more than 87% of distance visual impairment is due to avoidable causes. Women bear a disproportionately large burden of the problem.
Objectives:To perform an eyecare program wide analysis of utilization data, disaggregated by sex, age and presenting visual acuity, in order to investigate if utilization varied with gender, and if so at what level of services.Methods: Retrospective one-year data (July 2016-June 2017), collected as part of a north-Indian eyecare program was analyzed for sex-based differences. It consisted of rural and urban attendance at vision centers and camps at primary level, plus walk-in access and cataract operations at rural secondary, and urban tertiary levels.Results: At primary and secondary levels in rural areas, significantly fewer women than men accessed vision centers and camps, and received cataract surgery at the secondary hospital, respectively. This trend was reversed in urban areas, both at primary level, and at tertiary hospital. Cataract surgical patients were further stratified by pre-operative visual acuity in better eye, and at both levels significantly more women than men were blind at time of surgery.Conclusions: Service utilization by women varies significantly and unpredictably within a single eyecare program. Collection and analysis of sex-disaggregated data is needed at all locations and levels of care, to determine inequity and plan interventions.