title: Reversal in gender valuations of cataract surgery after the implementation of free screening and low-priced high-quality surgery in a rural population of southern China.
abstract: OBJECTIVE
  To assess the impact of community outreach and the availability of low-cost surgeries [500 Renminbi (RMB) or 65 United States dollars (US$) per surgery] on the willingness to pay for cataract surgery among male and female rural-dwelling Chinese.
  
  
  METHODS
  Cross-sectional willingness-to-pay surveys were conducted at the initiation of a cataract outreach programme in June 2001 and then again in July 2006. Respondents underwent visual acuity testing and provided socio-demographic data.
  
  
  RESULTS
  In 2001 and 2006, 325 and 303 subjects, respectively, were interviewed. On average the 2006 sample subjects were of similar age, more likely to be female (p < 0.01), illiterate (p < 0.01), and less likely to come from a household with annual income of less than US$789 (62% vs. 87%, p < 0.01). Familiarity with cataract surgery increased from 21.2% to 44.4% over the 5 years for male subjects (p < 0.01) and 15.8%-44.4% among females (p < 0.01). The proportion of respondents willing to pay at least 500 RMB for surgery increased from 67% to 88% (p < 0.01) among male subjects and from 50% to 91% (p < 0.01) among females.
  
  
  CONCLUSIONS
  Five years of access to free cataract testing and low-cost surgery programmes appears to have improved the familiarity with cataract surgery and increased the willingness to pay at least 500 RMB (US$65) for it in this rural population. Elderly women are now as likely as men to be willing to pay at least 500 RMB, reversing gender differences present 5 years ago.
authors.affiliation: Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA. ebaruwa@jhsph.edu
authors.forename: Elaine
authors.initials: E
authors.lastname: Baruwa
authors.forename: Jonathan
authors.initials: J
authors.lastname: Tzu
authors.forename: Nathan
authors.initials: N
authors.lastname: Congdon
authors.forename: Mingguang
authors.initials: M
authors.lastname: He
authors.forename: Kevin D
authors.initials: KD
authors.lastname: Frick
mesh_terms: D000368:Aged; D002386:Cataract / Q000175:diagnosis / Q000191:economics / Q000453:epidemiology*; D002387:Cataract Extraction / Q000191:economics* / Q000592:standards*; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006297:Health Services Accessibility / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000191:economics*; D009017:Morbidity / Q000639:trends; D011159:Population Surveillance; D011785:Quality Assurance, Health Care / Q000639:trends*; D012189:Retrospective Studies; D012424:Rural Population; D017678:Sex Distribution