1. Gender and blindness in Tanzania: Trying to think outside the eye care box Marceline Finda Kilimanjaro Centre for Community Ophthalmology

2. Challenges Elderly women often the most marginalized in society Blindness often leads to a sense of shame among women Health care systems generally not women friendly – Even when brought closer to the community

3. Working within the health system…. likely not adequate to address the problem Awareness Promotion to village leaders, church leaders, posters, radio announcements Accessibility Outreach to provide transport for people to hospital for surgery Affordability Made cataract surgery within the capacity of the population to pay

4. Experience in Tanzania & other countries in eastern Africa We can increase use of services by men and women….but still not achieving gender equity

5. KCCO’s ongoing learning… Women talking to women – Sentinel program Women as entrepreneurs and eye care promoters Microfinance and eye health – Taking advantage of existing microfinance groups to spread eye-care messages

6. Women as eye care advocates… and entrepreneurs Entrepreneurship; – Women were given basic entrepreneurship training – Some were provided with funds to start business – They were asked to advocate eye care services Increase in eye care uptake by both men and women – Still not enough

7. Entrepreneurship…lessons learned Some women were highly committed in both the business and in eye care advocacy Some women focused only on their new businesses Some did neither Although program was productive altogether, it was time consuming. Microfinance!

8. Mostly situated in rural settings Most members are women Their main goal is to alleviate poverty In many villages, every woman belongs to a group Regular meetings– often once a week Other health programs have used microfinance to spread specific messages (…but not all successful) Why microfinance?

9. About eye health Microfinance members were trained on eye heath, diabetes and physical disabilities The members then talked to and referred people to the eye- outreach clinics

10. Challenges and limitations Financial problems – Transport costs – Other NGOs Other more important diseases – Malaria, HIV, malnutrition; Need for counseling

11. Next step…potential for working with Zambia Most groups did not practice microfinance – Group income generating activities Groups are involved in other activities – Adult literacy, nutrition, – Growth-monitoring – HIV/AIDS and malaria. – Home based care (HBC)

12. Upcoming plans Try other settings Counseling-training Assisting the groups, can be: – Transport – Loans – Income generating activities