BMJ Open Ophthalmology (Feb 2024)

Needs and views on eye health and women’s empowerment and theory of change map: implication on the development of a women-targeted eyecare programme for older Zanzibari craftswomen

  • Ving Fai Chan,
  • Fatma Omar,
  • Eden Mashayo,
  • Damaris Mulewa,
  • Ai Chee Yong,
  • Christine Graham,
  • Ronnie Graham,
  • Carlos Price-Sanchez,
  • Omar Othman,
  • Kayleigh McCluskey

DOI
https://doi.org/10.1136/bmjophth-2023-001292
Journal volume & issue
Vol. 9, no. 1

Abstract

Read online

Objectives To assess needs and views regarding eye health and empowerment from craftswomen’s perspectives to develop a theory of change (ToC) for a women-targeted eyecare programme.Material and methods Eighteen stakeholders participated in a 2-day consultation workshop in Zanzibar. The composition was (1) 15 women and 3 men; (2) Unguja (n=8), Pemba (n=6) and Tanzania mainland (n=4) and (3) craftswomen (n=14) and governmental stakeholders (n=4). Thematic analysis determined the craftswomen’s needs and views regarding eye health and empowerment and subsequently inputs, activities, outputs, outcomes and impact to develop the programme’s initial ToC. In refining the initial ToC, we used insights from a qualitative study suggesting that improved near vision is perceived by craftswomen as a potential source of empowerment across economic, psychological, social, political and educational dimensions.Results The eye conditions experienced by the craftswomen were eye irritation caused by foreign bodies, the need for near spectacles and other eye morbidities. They were advised by the cooperatives to visit eye health centres for treatment. The main barriers to accessing services were inaccessibility and unaffordability of eye services and a lack of eye health knowledge and practices. Nineteen subthemes on women empowerment (economic n=4, social n=4, psychological n=6, education n=2 and political n=3) were obtained. We created a ToC on how investing in improving craftswomen near vision could achieve empowerment.Conclusion The participants provided insights into their needs and how they would like the eyecare programme to be implemented and how they see they could be empowered in the process.