Does Cataract Surgery Alleviate Poverty? Evidence from a Multi-Centre Intervention Study Conducted in Kenya, the Philippines and Bangladesh
Open Access
- 9 November 2010
- journal article
- Published by Public Library of Science (PLoS) in PLOS ONE
- Vol. 5 (11), e15431
- https://doi.org/10.1371/journal.pone.0015431
Abstract
Poverty and blindness are believed to be intimately linked, but empirical data supporting this purported relationship are sparse. The objective of this study is to assess whether there is a reduction in poverty after cataract surgery among visually impaired cases. A multi-centre intervention study was conducted in three countries (Kenya, Philippines, Bangladesh). Poverty data (household per capita expenditure – PCE, asset ownership and self-rated wealth) were collected from cases aged ≥50 years who were visually impaired due to cataract (visual acuity<6/24 in the better eye) and age-sex matched controls with normal vision. Cases were offered free/subsidised cataract surgery. Approximately one year later participants were re-interviewed about poverty. 466 cases and 436 controls were examined at both baseline and follow-up (Follow up rate: 78% for cases, 81% for controls), of which 263 cases had undergone cataract surgery (“operated cases”). At baseline, operated cases were poorer compared to controls in terms of PCE (Kenya: $22 versus £35 p = 0.02, Bangladesh: $16 vs $24 p = 0.004, Philippines: $24 vs 32 p = 0.0007), assets and self-rated wealth. By follow-up PCE had increased significantly among operated cases in each of the three settings to the level of controls (Kenya: $30 versus £36 p = 0.49, Bangladesh: $23 vs $23 p = 0.20, Philippines: $45 vs $36 p = 0.68). There were smaller increases in self-rated wealth and no changes in assets. Changes in PCE were apparent in different socio-demographic and ocular groups. The largest PCE increases were apparent among the cases that were poorest at baseline. This study showed that cataract surgery can contribute to poverty alleviation, particularly among the most vulnerable members of society. This study highlights the need for increased provision of cataract surgery to poor people and shows that a focus on blindness may help to alleviate poverty and achieve the Millennium Development Goals.Keywords
This publication has 22 references indexed in Scilit:
- The Impact of Cataract Surgery on Activities and Time-Use: Results from a Longitudinal Study in Kenya, Bangladesh and the PhilippinesPLOS ONE, 2010
- The impact of cataract surgery on health related quality of life and time use in Kenya, Bangladesh and the PhilippinesJournal of Epidemiology and Community Health, 2009
- A Case-Control Study to Assess the Relationship between Poverty and Visual Impairment from Cataract in Kenya, the Philippines, and BangladeshPLoS Medicine, 2008
- Poverty, wealth inequality and health among older adults in rural CambodiaSocial Science & Medicine, 2008
- Poverty and blindness in Pakistan: results from the Pakistan national blindness and visual impairment surveyBMJ, 2007
- Rapid assessment of avoidable blindness in Negros Island and Antique District, PhilippinesBritish Journal of Ophthalmology, 2007
- Cataract visual impairment and quality of life in a Kenyan populationBritish Journal of Ophthalmology, 2007
- Rapid assessment of avoidable blindness and needs assessment of cataract surgical services in Satkhira District, BangladeshBritish Journal of Ophthalmology, 2006
- EQ-SD: a measure of health status from the EuroQol GroupAnnals of Medicine, 2001
- A Not Quite as Quick but Much Cleaner Alternative to the Expanded Programme on Immunization (EPI) Cluster Survey DesignInternational Journal of Epidemiology, 1996