Globally, 285 million people are visually impaired, a quarter of whom live in India. The disease burden results in significantly lower employment and productivity. The national blindness prevention strategy aims at eyecare promotion through health behaviour change by raising awareness. Traditionally, this strategy relies on healthcare information disseminated through radio, television, mass media campaigns, printed medium, and interpersonal communication. Despite their appeal, these communication channels have constraints related to their cost and infrastructure. Moreover, social remoteness resulting from gender and cultural bias, illiteracy, rigid societal hierarchy, and sociocultural prejudices, acts as a major barrier to accessing this information for people from marginalised and disadvantaged communities.
Alongside the inadequacies of the traditional information channels, there has been a demographic frameshift in many developing countries like India, which results in differential and patchy developmental practices. Consequently, India is now facing an aging population and an epidemiological change toward non-communicable diseases. This has been further compounded by rapid and unplanned urbanisation, economic migration to larger cities with over-burdened infrastructure, a lack of universal access to healthcare, and a widening digital divide. Unsurprisingly, this is putting enormous pressure on existing inadequate public health services and worsening eye health outcomes for those belonging to socioeconomically challenged backgrounds.
However, effective public health service providers can address poor eye health outcomes, using simple measures like addressing the knowledge gap amongst disadvantaged members of society, easier access to regular eye check-up clinics, advocating hygienic practices, dispelling myths and unscientific healthcare practices and taboos, provision of cost-effective surgeries, and mobile health services. This approach has the potential of empowering the communities with new knowledge by addressing social determinants that act as a barrier to accessing eye healthcare, and their negative impact on vision. Additionally, this strategy is in alignment with the United Nation’s vision of sustainable developmental goals for 20301, as this will help poverty reduction, increase productivity, and address the inequity of health, education, and gender. This argues for the case of improving eye health care as principally a human developmental issue. Aligned with the UN strategy, is the ambitious goal of the World Health Organisation to provide Universal Eye Care, irrespective of geographical boundaries and socioeconomic divide2.
Over the past decade, there has been an exponential increase in social media usage in developing nations like India. In particular, the penetration of WhatsApp, a social media platform that allows the exchange of audio-visual material through a free-to-use user-friendly platform, has increased to the extent that this may be regarded as an important communication channel, particularly so for the rural, remote, and socioeconomically challenged communities3. WhatsApp has the potential to reach all communities, rich or poor, urban or rural, and facilitate two-way communication in real-time. In the Indian context, it provides a desirable platform for health communication and can be used in eye healthcare care, to improve outcomes.
In my thesis titled “WhatsApp In Health Communication: The Case Of Eye Health In Deprived Settings In India” [link to full PDF], I have tried to explore the benefits and challenges of using a social media communication platform like WhatsApp in addressing the knowledge gap on eye health among deprived members of the society4–6. The participants in this project were a large urban tertiary eye care institution (Susrut Eye Hospital) and a group of women residents from a deprived setting in a village near the eastern Indian city of Kolkata. Over a series of educational sessions undertaken at a school close to the deprived community, audio-visual content matter on eye health, carefully prepared by Susrut, was disseminated using WhatsApp as the health communication channel. This process was facilitated by two neo-literate facilitators who were also resident members of the deprived community, and participants were actively encouraged to pose questions and queries to Susrut using the WhatsApp channel.
Fig 1. Conceptual flow of information in the study
Fig 2. The flow of information between the providers and the recipients through WhatsApp
Acceptability of WhatsApp-based information dissemination amongst the study participants was high with reported benefits of increased awareness of eye diseases, their preventative management, remedial measures, and the availability of affordable eye care services. Additionally, study participants found WhatsApp technology appealing and intuitive. The resultant increase in self-confidence, consequent to heightened awareness, boosted social empowerment and enabled study participants to challenge prevalent social and cultural norms.
In conclusion, my study demonstrated that WhatsApp can be effectively used as a suitable vehicle for information dissemination on eye care in mediating behavioural change in deprived settings. Findings from this study may be considered in developing policies that develop and disseminate eye care information. This low-cost technology has the potential of being used as a data collection tool, for information governance and surveillance, and in situations of urgency. The wider implications and impact of this study lie in disseminating healthcare information related to other important public health issues to marginalised populations.
1. THE 17 GOALS | Sustainable Development, https://sdgs.un.org/goals
2. World Health Organization. Universal eye health: a global action plan 2014-2019. Geneva, Switzerland: World Health Organization. https://www.who.int/publications/i/item/universal-eye-health-a-global-action-plan-2014-2019
3. WhatsApp. Statista Research Department. https://www.statista.com/topics/2018/whatsapp/#topicOverview
4. Maitra C, Rowley J. Delivering eye health education to deprived communities in India through a social media-based innovation. Health Inf Libr J 2021; 38: 139–142. http://onlinelibrary.wiley.com/doi/abs/10.1111/hir.12370
5. Maitra C. WhatsApp In Health Communication – The Case Of Eye Health In Deprived Settings In India. Manchester Metropolitan University, https://e-space.mmu.ac.uk/627599/1/WhatsApp%20In%20Health%20Communication%20-%20The%20Case%20Of%20Eye%20Health%20In%20Deprived%20Settings%20In%20India.pdf (2021).
6. Maitra C, Rowley J. Using a social media based intervention to enhance eye health awareness of members of a deprived community in India. Inf Dev 2021; http://journals.sagepub.com/doi/10.1177/02666669211013450