Introduction: Urologic disease (UD) is highly prevalent in low- and middle-income countries (LMIC). Concurrently, the inability to maintain employment or provide care for family are significant factors that contribute to extreme poverty in these countries. The impact of urologic disease on economic productivity and caretaking responsibilities in developing countries is poorly understood.
Methods: We conducted a prospective survey-based study of patients treated during two separate global health trips from 2019-2021 with the charity Global Surgical Expedition. Patients completed a 17-item survey with focus on urologic disease, work and caretaking responsibilities, and financial data. Items from the Work Productivity and Activity Impairment Questionnaire (WPAI) were used to assess financial impact.
Results: A total of 114 patients completed surveys, with 61 having financial data sufficient for analysis. Most common presenting urologic diagnosis category included Female (pelvic organ prolapse, urinary incontinence)- 41.4%, BPH/strictures- 28.4%, urolithiasis- 19.8%, oncology- 7.7%, and other- 2.6%. Diagnoses were not mutually exclusive. Overall, 87.7% and 36.8% reported a negative impact of urologic disorders on job and caretaking responsibilities, respectively. 9 patients (7.7%) were unemployed secondary to their UD. Mean percent work time missed and percent impairment while working due to UD was 21.8% and 42.0%, respectively. Overall activity impairment due to UD was 30.4%. Mean weekly income of respondents was BZ $461 BZD (approximately $230.50 USD). Accordingly, the percent overall work impairment resulted in $59.10 BZD per capita in lost potential income per week. This represents a loss of 12.8% of total income attributable to UD. 88.6% of patients reported that cure of UD would increase ability to work and/or care for family.
Conclusions: In Belize, UD results in significant impairment and time missed as related to work and caretaking responsibilities. This impairment is associated with a significant level of lost income. Focused efforts are necessary to provide urologic surgeries in developing countries as not only do they impact quality of life but also deleteriously impact financial health of patients and families.
Source of Funding: University of Virginia Center for Global Inquiry and Innovation
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