Social Factors Determining the Experience of Blindness among Pregnant Women in Developing Countries: The Case of India

Abstract

Approximately 10 million pregnant women around the world develop night blindness annually. In India, one in 11 pregnant women suffers from night blindness. This study used a nationally representative sample of 35,248 women from India between the ages of 15 and 49 who had given birth in the past five years to understand the effect of women's empowerment on developing blindness during pregnancy. Findings from logistic regression showed that several empowerment-related factors, including women's increased age at the birth of their first child, high school education, and participation in their own health care decisions, significantly reduced the odds of developing blindness, whereas their experience of spousal control, humiliation, and physical abuse significantly increased the odds of developing blindness during pregnancy. Interestingly, antenatal care visits that included nutritional advice and iron supplements during pregnancy had no effect on blindness after controlling for other factors. To reduce blindness during pregnancy in India, more attention should be given to delaying age at marriage and first birth; improving women and girl's education and autonomy; and implementing strategies to reduce spousal control, humiliation, and abuse.

Access and utilisation of maternity care for disabled women who experience domestic abuse: a systematic review

“…In a study of 120 pregnant women in the USA with spinal cord injury, 56% reported that their local hospital could not accommodate their disability needs when they gave birth [37]. Similar findings emerged in a large nationally representative survey of pregnant women (n = 35,248) across India [38]. Of the women experiencing pregnancy related blindness (12%), nearly 60% reported that they were concerned about the quality of maternity services.…”

“…Eight studies highlighted barriers which compromise access to maternity care [35,37,38,40-42,44,45], relating to: mental health diagnosis; poor relationships with health professionals; environmental barriers; domestic abuse.…”

“…Four studies suggested that maternity care facilities are ill-equipped to provide services for disabled women who experience domestic abuse [37,38,44,45]. In a study of 120 pregnant women in the USA with spinal cord injury, 56% reported that their local hospital could not accommodate their disability needs when they gave birth [37].…”

“…There may also be restrictions within these policies themselves, whereby insurance schemes will not fund certain procedures or cater for the extra time required to carry out examinations when accommodating women with additional needs. Moreover, in countries where social insurance systems do not exist, the financial barriers to accessing maternity care are great, particularly for disabled women [38]. The high cost of transport was highlighted in two studies [38,45] and this was further compounded when women were refused treatment in their local hospital because of their disability and had to find care elsewhere.…”

Determinants of gestational night blindness in pregnant women from Rio de Janeiro, Brazil

“…In addition, the prevalence of XN can also indicate nutritional deficiency due to, for example, acute changes in living conditions, economic crises or reduction in employment rates, which affect the prevalence of XN in pregnant women and pre-school children (15) . Inadequate dietary intake of vitamin A is the most recognized risk factor for VAD (2,8,(16)(17)(18) . However, other factors need to be further studied, such as lack of education, poor sanitation, food insecurity, low maternal socioeconomic status, poorly diversified and plant-based diets and low consumption of vitamin A-rich foods, whose association with VAD has been well described in studies conducted in Asia and Africa (16,19,20) .…”