International Women’s Day 2022 #BreakTheBias

International Women’s Day is an important day to celebrate the achievements of women and to recognise the work that still needs to be done to end gender inequality. With this year’s theme to #BreakTheBias, we asked The Foundation’s CEO Dr Audrey Aumua to share her thoughts on gender inequality in eye care, and how we can all work towards breaking the bias in our workplaces, communities, and homes.

How does gender bias impact eye care?

55% of the world’s needlessly blind are women. In Papua New Guinea, it’s a staggering 61%. This is due to a variety of factors. One is that on the whole, women deliver global health while men lead it. Women are underrepresented in key decision making positions, and it has a clear impact on the accessibility and experience of health services for women.

Harmful gender norms also play a big part. In some places, women can only visit an eye clinic if accompanied by a chaperone. In other instances, men and boys – often viewed as the breadwinners in the family unit – will be prioritised for healthcare ahead of women.

Not only is vision- impairment higher amongst women, but they also more acutely feel the indirect impacts. Women and girls are often expected to leave work or school so they can stay home and care for a blind or vision-impaired family member. This further exacerbates inequalities in education and income, which contributes to women’s poorer knowledge of, demand for, and uptake of sight-saving services. It is a cycle that must be broken by improving women's access to health care, education, and work.

As in many other cultures, women form the backbone of Pacific communities. If we want to see sustainable impacts from development activity in the Pacific, we must do better at getting eye care services to women.

How is The Fred Hollows Foundation NZ working to break the bias?

The Foundation is working hard to champion women’s rights and gender equity at all levels.

In the workforce, we recruit women into leadership positions and help support younger women to reach senior roles through mentorship and development opportunities. Our Workforce Support Programme focuses on upskilling women so they can stick it out in the toughest of conditions, and our gender-equal work policies ensure things like good parental leave are included in employment agreements, even when this wasn’t the norm at the time in some countries.

64% of graduates from our tertiary eye care programmes have been women, and we are continuing to develop ways of supporting women in education. For example, by creating online programmes for eye care students so they can remain in country to study – as many women are unable to leave family responsibilities to complete the required courses overseas.

Lastly, we advocate for women to be in key decision making positions, and support research on gender inequalities. We know that gender issues are often hidden because not enough data is collected to show the full picture, and sometimes only the economic arguments for gender equity will be heard, so a key focus of ours is building an evidence base that can be used to inform policy development and prioritisation.

As a Pacific Leader, what else can be done to support inclusivity, diversity and equity across the Pacific?

Looking forward, as Chief Executive Officer of The Foundation, a strong focus for me and my team is striving towards equal access to eye care for everyone.

The Fred Hollows Foundation NZ is currently expanding its focus on supporting Pacific Governments to achieve integrated people-centred eye care and Universal Eye Health Care, so that all people can access quality eye care when and where they need it without suffering financial hardship. There is simply no way these ambitions can be realised without an understanding and explicit focus on addressing gender inequalities and their intersection with eye health.

Pacific women’s schedules often revolve around the needs of children and other members of the household and aren’t planned or predictable. To reach these women, eye care delivery must decentralise. We must move away from cities and hospitals and go to the communities where the need is greater. The Fred Hollows Foundation NZ supports an average of 230 outreaches per year with significant results. Furthermore, by bundling eye screening or treatment with other Outreach services such as cervical screening or childhood immunisations, time-poor women can access multiple services with one visit. We are also supporting stronger integration of eye care within the Non-Communicable Disease sector and leveraging opportunities for eye screening of diabetic patients to reduce irreversible sight loss.

If we don’t act soon, rates of blindness will double by 2050. We can’t afford to stand by while more generations of women continue to experience a disproportionate burden of avoidable blindness.

The Foundation will continue to push for gender equality in all aspects of its work, both internally and externally, because quite simply, we know that health systems will be stronger when the women who deliver them have an equal say in the design of national health plans, policies, and systems.

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