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Engendered Access or Engendered Care?
A central feature of many developing countries is the presence of significant gender differentials in health outcomes. Two potential factors that can account for this are that females access treatment later than males and that they receive differential care at the medical facility. This paper explores both of these in the context of eye care. The paper studies diagnostic and surgical outcomes of 60,000 patients who sought treatment over a three-month period in 2012 at the Aravind Eye Hospital in Madurai, Tamil Nadu. The results show that at presentation, women have worse diagnoses than men for indicators of symptomatic illness. To resolve gender-based health inequalities in developing countries, we need to know where these inequalities lie. This paper finds them in access but not care. The findings suggest that women seek treatment later than men for symptomatic illness. That no such gender differential exists for asymptomatic diseases suggests that women do not necessarily go for regular preventive check-ups at a lower frequency than men. The paper finds no systematic evidence that women and men receive differential medical treatment.
We are very grateful to the staff of Aravind Eye Hospital, in particular Ganesh Babu and R D Thulsiraj, for their support and collaboration. We thank Abraham Holland and Misha Sharma at the Centre for Microfi nance for providing invaluable local project management, Amelie Schiprowski for excellent research assistance, and Dr Tomasz Mlynczak for his medical expertise. We thank an anonymous referee for useful comments. Ray acknowedges funding from the National Science Foundation of the United States under grant SES-1261560. We are also grateful to the International Growth Centre for partial funding of this research.
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