{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T18:00:50Z","timestamp":1774980050326,"version":"3.50.1"},"reference-count":35,"publisher":"BMJ","issue":"11","license":[{"start":{"date-parts":[[2024,11,14]],"date-time":"2024-11-14T00:00:00Z","timestamp":1731542400000},"content-version":"unspecified","delay-in-days":13,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004336","name":"Novartis","doi-asserted-by":"publisher","award":["NPO 6240 R8898CPH"],"award-info":[{"award-number":["NPO 6240 R8898CPH"]}],"id":[{"id":"10.13039\/100004336","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"publisher","award":["R2806CPH"],"award-info":[{"award-number":["R2806CPH"]}],"id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2024,10,24]]},"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To understand if presbyopia correction could empower older craftswomen entrepreneurs living in Zanzibar.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Mixed-method, before-after intervention study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Unguja and Pemba islands, Zanzibar.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>209 craftswomen (weaving, tailoring and sewing, pottery and producing oil and making soaps) 40 years and older with correctable presbyopia, with no other ocular morbidities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Intervention<\/jats:title>\n                    <jats:p>Eye health assessment and near vision spectacle correction for 6\u2009months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary and secondary outcomes<\/jats:title>\n                    <jats:p>Change in economic, social, psychological and political empowerment (4-point Likert scale responses) before and after correction. Odds ratios were calculated to determine the likelihood of upward movement on the Likert scale. Five focus group interviews were conducted to explore the craftswomen\u2019s daily experiences concerning vision correction and empowerment, and subsequently, narrative analysis was conducted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of the 209 craftswomen who completed the baseline survey from 4 to 21 April 2022, 157 (75.1%) were successfully followed up from 6 to 27 October 2022. Craftswomen reported significantly greater economic, social, psychological and political empowerment in 14 out of 18 statements (77.8%) (p&lt;0.05). Qualitative responses showed that after correction, craftswomen reported having greater autonomy in running the business and improved income, better decision-making power for their business and children, greater independence and confidence and greater participation in problem-solving for the community and appointing leaders. We did not observe a significant change in the following: ability to make decisions for their family, understanding their capabilities, ability to be elected as a leader and ability to advise government leaders.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The correlation between presbyopia correction and empowerment among older Zanzibari craftswomen is mostly positive. Some aspects of empowerment require further investigation with an extended timeframe.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2024-086624","type":"journal-article","created":{"date-parts":[[2024,11,14]],"date-time":"2024-11-14T07:15:44Z","timestamp":1731568544000},"page":"e086624","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Correcting near vision impairment and women\u2019s empowerment: a before-after mixed-methods study among older Zanzibari craftswomen"],"prefix":"10.1136","volume":"14","author":[{"given":"Fatma","family":"Omar","sequence":"first","affiliation":[{"name":"Zanzibar Ministry of Health, Zanzibar, Mkoa wa Unguja Mjini Magh, Tanzania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Omar Juma","family":"Othman","sequence":"additional","affiliation":[{"name":"Zanzibar Ministry of Health, Zanzibar, Mkoa wa Unguja Mjini Magh, Tanzania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ai Chee","family":"Yong","sequence":"additional","affiliation":[{"name":"Centre for Public Health, Queen's University Belfast, Belfast, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emma","family":"McConnell","sequence":"additional","affiliation":[{"name":"Centre for Public Health, Queen's University Belfast, Belfast, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Damaris","family":"Mulewa","sequence":"additional","affiliation":[{"name":"Independent Researcher, Nairobi, Kenya"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christine","family":"Graham","sequence":"additional","affiliation":[{"name":"Centre for Public Health, Queen's University Belfast, Belfast, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kajal","family":"Shah","sequence":"additional","affiliation":[{"name":"Dublin Institute of Technology, Dublin, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michelle Fernandes","family":"Martins","sequence":"additional","affiliation":[{"name":"Centre for Public Health, Queen's University Belfast, Belfast, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adrianna","family":"Farmer","sequence":"additional","affiliation":[{"name":"Centre for Public Health, Queen's University Belfast, Belfast, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ronnie","family":"Graham","sequence":"additional","affiliation":[{"name":"Independent Researcher, Edinburgh, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eden","family":"Mashayo","sequence":"additional","affiliation":[{"name":"Vision Care Foundation, Dar-es-Salaam, Tanzania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4968-7953","authenticated-orcid":false,"given":"Ving Fai","family":"Chan","sequence":"additional","affiliation":[{"name":"Centre for Public Health, Queen's University Belfast, Belfast, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2024,11,14]]},"reference":[{"key":"2025121407472524000_14.11.e086624.1","doi-asserted-by":"crossref","first-page":"e888","DOI":"10.1016\/S2214-109X(17)30293-0","article-title":"Magnitude, temporal trends, and projections of the global prevalence of blindness and distance and near vision impairment: a systematic review and meta-analysis","volume":"5","author":"Bourne","year":"2017","journal-title":"Lancet Glob Health"},{"key":"2025121407472524000_14.11.e086624.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2018.04.013"},{"key":"2025121407472524000_14.11.e086624.3","doi-asserted-by":"publisher","DOI":"10.1001\/archopht.126.12.1731"},{"key":"2025121407472524000_14.11.e086624.4","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1016\/j.ophtha.2013.06.051","article-title":"Age-related prevalence and met need for correctable and uncorrectable near vision impairment in a multi-country study","volume":"121","author":"He","year":"2014","journal-title":"Ophthalmology"},{"key":"2025121407472524000_14.11.e086624.5","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1111\/aos.12308","article-title":"Review of the impact of presbyopia on quality of life in the developing and developed world","volume":"92","author":"Goertz","year":"2014","journal-title":"Acta Ophthalmol"},{"key":"2025121407472524000_14.11.e086624.6","doi-asserted-by":"publisher","DOI":"10.1167\/iovs.10-6353"},{"key":"2025121407472524000_14.11.e086624.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2006.01.028"},{"key":"2025121407472524000_14.11.e086624.8","doi-asserted-by":"publisher","DOI":"10.1167\/iovs.05-1192"},{"key":"2025121407472524000_14.11.e086624.9","unstructured":"World Economic Forum . Eyeglasses for global development: bridging the visual divide, 2016. Available: http:\/\/www3.weforum.org\/docs\/WEF_2016_EYElliance.pdf"},{"key":"2025121407472524000_14.11.e086624.10","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1097\/APO.0000000000000485","article-title":"Vision Impairment and Productivity Among Female Garment Workers in Bangladesh: A Cohort Study","volume":"11","author":"Ahmed","year":"2022","journal-title":"Asia Pac J Ophthalmol (Phila)"},{"key":"2025121407472524000_14.11.e086624.11","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2015.04.014"},{"key":"2025121407472524000_14.11.e086624.12","doi-asserted-by":"crossref","first-page":"e1019","DOI":"10.1016\/S2214-109X(18)30329-2","article-title":"Effect of providing near glasses on productivity among rural Indian tea workers with presbyopia (PROSPER): a randomised trial","volume":"6","author":"Reddy","year":"2018","journal-title":"Lancet Glob Health"},{"key":"2025121407472524000_14.11.e086624.13","doi-asserted-by":"crossref","first-page":"4","DOI":"10.4102\/aveh.v75i1.357","article-title":"Near vision correction and work productivity among textile workers","volume":"75","author":"Naidoo","year":"2016","journal-title":"Afr Vis Eye Health"},{"key":"2025121407472524000_14.11.e086624.14","doi-asserted-by":"crossref","first-page":"119","DOI":"10.15415\/jmrh.2015.12008","article-title":"Impact of Uncorrected Vision on Productivity-A study in an Industrial setting a Pair of Spectacles","volume":"1","author":"Pradhan","year":"2015","journal-title":"JMRH"},{"key":"2025121407472524000_14.11.e086624.15","unstructured":"Dalberg Global Development Advisors . Impact study of Essilor\u2019s Eye Mitra optician programme in India (a programme of the Essilor Group\u2019s 2.5 New Vision Generation division), 2015. Available: https:\/\/www.essilorseechange.com\/website\/eye-mitra-creating-ripples-of-impact-in-india-through-inclusive-vision-care"},{"key":"2025121407472524000_14.11.e086624.16","doi-asserted-by":"publisher","DOI":"10.1167\/iovs.08-3154"},{"key":"2025121407472524000_14.11.e086624.17","doi-asserted-by":"crossref","unstructured":"Chan VF , Naidoo J , Chinanayi FS , et al . Near vision correction and quality of life among textile factory workers in Durban. Afr Vis Eye Health 2017;76. doi:10.4102\/aveh.v76i1.384","DOI":"10.4102\/aveh.v76i1.384"},{"key":"2025121407472524000_14.11.e086624.18","first-page":"370","article-title":"Impact of Presbyopia and Its Correction in Low- and Middle-Income Countries","volume":"7","author":"Chan","year":"2019","journal-title":"Asia Pac J Ophthalmol (Phila)"},{"key":"2025121407472524000_14.11.e086624.19","doi-asserted-by":"crossref","first-page":"e489","DOI":"10.1016\/S2214-109X(20)30488-5","article-title":"The Lancet Global Health Commission on Global Eye Health: vision beyond 2020","volume":"9","author":"Burton","year":"2021","journal-title":"Lancet Glob Health"},{"key":"2025121407472524000_14.11.e086624.20","doi-asserted-by":"crossref","first-page":"e130","DOI":"10.1016\/S2214-109X(20)30425-3","article-title":"Trends in prevalence of blindness and distance and near vision impairment over 30 years: an analysis for the Global Burden of Disease Study","volume":"9","author":"Bourne","year":"2021","journal-title":"Lancet Glob Health"},{"key":"2025121407472524000_14.11.e086624.21","unstructured":"UN Women Data Hub . Women and men in Zanzibar: Facts and Figures. 2019. Available: https:\/\/data.unwomen.org\/publications\/women-and-men-zanzibar-facts-and-figures"},{"key":"2025121407472524000_14.11.e086624.22","doi-asserted-by":"crossref","DOI":"10.1136\/bmjophth-2023-001283","article-title":"Refractive error, eye care needs and attitude towards spectacle wearing among older Zanzibari craftswomen and implications for developing women-targeted services: a cross-sectional study","volume":"8","author":"Chan","year":"2023","journal-title":"BMJ Open Ophth"},{"key":"2025121407472524000_14.11.e086624.23","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0286315","article-title":"How does a pair of near-vision spectacle correction empower older Zanzibari craftswomen?: A qualitative study on perception","volume":"18","author":"Martins","year":"2023","journal-title":"PLoS One"},{"key":"2025121407472524000_14.11.e086624.24","unstructured":"Sebayang SK , Ferry E , Erni A . Women\u2019s empowerment and the use of antenatal care services in Southeast Asian countries. Rockville, Maryland, USA: ICF, 2017. Available: https:\/\/www.dhsprogram.com\/pubs\/pdf\/WP129\/WP129.pdf"},{"key":"2025121407472524000_14.11.e086624.25","unstructured":"Sen G . Empowerment as an approach to poverty, working paper series 97.07, background paper for the UNDP human development report. New York: UNDP, 1997."},{"key":"2025121407472524000_14.11.e086624.26","unstructured":"Chan VF , Omar F , Othman O . n.d. Women\u2019s Empowerment through Investing in Zanzibari Craftswomen\u2019s Eyesight (Version 1.0.0). doi:10.5281\/zenodo.13749309"},{"key":"2025121407472524000_14.11.e086624.27","first-page":"115","article-title":"An econometric analysis on the impact of busines confidence and investment on economic growth in post-apartheid South Africa","volume":"10","author":"De Jongh","year":"2018","journal-title":"Int J Econ Financ Stud"},{"key":"2025121407472524000_14.11.e086624.28","unstructured":"Santero T , Westerlund N . Confidence indicators and their relationship to changes in economic activity, 1996. Available: https:\/\/www.oecd-ilibrary.org\/content\/paper\/537052766455"},{"key":"2025121407472524000_14.11.e086624.29","unstructured":"Ellis A . Gender and economic growth in Tanzania: Creating opportunities for women. 2007."},{"key":"2025121407472524000_14.11.e086624.30","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1177\/1059601100252006","article-title":"Self-Limiting Behavior in Women","volume":"25","author":"Dickerson","year":"2000","journal-title":"Grp & Org Mgmt"},{"key":"2025121407472524000_14.11.e086624.31","doi-asserted-by":"crossref","DOI":"10.1016\/j.heliyon.2021.e06660","article-title":"Gendered stereotypes and norms: A systematic review of interventions designed to shift attitudes and behaviour","volume":"7","author":"Stewart","year":"2021","journal-title":"Heliyon"},{"key":"2025121407472524000_14.11.e086624.32","doi-asserted-by":"crossref","unstructured":"Quak E , Barenboim I . Female Entrepreneurship and Informality in Low- and Middle-Income Countries: What Have We Learned So Far. 2002. doi:10.19088\/MUVA.2022.001","DOI":"10.19088\/MUVA.2022.001"},{"key":"2025121407472524000_14.11.e086624.33","doi-asserted-by":"crossref","unstructured":"Krapfl JE , Blina K . Leadership and culture. Leadership and cultural change. Routledge, 2018:28\u201343.","DOI":"10.4324\/9780203713198-3"},{"key":"2025121407472524000_14.11.e086624.34","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1057\/s41287-017-0119-y","article-title":"The Contested Relationship Between Paid Work and Women\u2019s Empowerment: Empirical Analysis from Bangladesh","volume":"30","author":"Kabeer","year":"2018","journal-title":"Eur J Dev Res"},{"key":"2025121407472524000_14.11.e086624.35","doi-asserted-by":"publisher","DOI":"10.1111\/1467-7660.00125"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2024-086624","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,14]],"date-time":"2025-12-14T15:47:38Z","timestamp":1765727258000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2024-086624"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11]]},"references-count":35,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2024,11,14]]},"published-print":{"date-parts":[[2024,11]]}},"alternative-id":["10.1136\/bmjopen-2024-086624"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2024-086624","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,11]]}}}