title: Economic and social factors that influence households not willing to undergo cataract surgery.
abstract: OBJECTIVE
  Literature investigating barriers to cataract surgery is mostly done from the patient's point of view. However, many medical decisions are jointly taken by household members, especially in developing countries such as India. We investigated from the household head's (or representative's) perspective, households' view on those not willing to undergo cataract surgery along with the economic and social factors associated with it.
  
  
  METHODS
  A cross-sectional survey of four randomly selected village clusters in rural areas of Theni district, Tamil Nadu, India, was conducted to elicit the willingness to pay for cataract surgery by presenting "scenarios" that included having or not having free surgery available. The presentation of scenarios allowed the identification of respondents who were unwilling to undergo surgery. Logistic regression was used to estimate relationships between economic and social factors and unwillingness to undergo cataract surgery.
  
  
  RESULTS
  Of the 1271 respondents, 49 (3.85%) were not willing to undergo surgery if they or their family members have cataract even if free surgery were available. In the regression results, those with good understanding of cataract and its treatment were less likely to be unwilling to undergo cataract surgery. Those not reporting household income were more likely to be unwilling to undergo cataract surgery.
  
  
  CONCLUSIONS
  As a good understanding of cataract was an important predictor of willingness to undergo cataract surgery, health education on cataract and its intervention can improve uptake.
authors.forename: Muralikrishnan
authors.initials: M
authors.lastname: Radhakrishnan
authors.affiliation: Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Puducherry, India.
authors.forename: Rengaraj
authors.initials: R
authors.lastname: Venkatesh
authors.forename: Vijayakumar
authors.initials: V
authors.lastname: Valaguru
authors.forename: Kevin D
authors.initials: KD
authors.lastname: Frick
mesh_terms: D000328:Adult; D002386:Cataract / Q000191:economics* / Q000453:epidemiology; D002387:Cataract Extraction / Q000191:economics*; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D003906:Developing Countries; D005191:Family Characteristics; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D012424:Rural Population; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D055815:Young Adult