Understanding the Role of Gender in Trichiasis Case Finding in Tanzania

ABSTRACT

Purpose

Despite the importance of trachomatous trichiasis (TT) case-finding activities in national trachoma elimination campaigns, the scientific literature on the determinants of good outcomes – finding and managing all TT cases – is still sparse. In Tanzania, we studied differences in case finding activities and outcomes between male and female case finders.

Methods

This case study was conducted in two districts in Tanzania in 2021–2022. Quantitative data were extracted from case finder forms and outreach registers, and qualitative data were collected through direct observation, interviews, and focus group discussions.

Results

Across both districts, more males were trained as case finders (68%). Productivity differences were minor, not statistically significant, between male and female case finders regarding the number of households visited and the number of adults examined. Whether identified by a male or female case finder, similar proportions of men and women suspected to have TT were subsequently managed. There is evidence that suggests that female case finders were more active in supporting suspected and confirmed TT cases to access follow-up services.

Conclusion

The findings do not suggest that gender balance in the recruitment of TT case finders would have led to better TT campaign outcomes in the study districts. Programmes may benefit from integrating gender considerations in the design and implementation of case finding activities – e.g. in monitoring gender differences among case finders and the relationship with key outcomes. This study also highlights how women with TT face greater barriers to care.

KEYWORDS:

• Gender
• Trachoma elimination
• trichiasis
• trichiasis case finders

Acknowledgments

We wish to thank the local communities and TT case finders that welcomed the study team in Chamwino and Kilindi districts, as well as national, regional, and local authorities for their cooperation for the implementation of this study.

Disclosure statement

No potential conflict of interest was reported by the authors.

This submission has not been published anywhere previously and that it is not simultaneously being considered for any other publication.

Financial support

This study was funded by Sightsavers International/Conrad N. Hilton Foundation.

Additional information

Funding

The work was supported by the Sightsavers International and the Conrad N. Hilton Foundation.