Dau Hallie, Nankya Esther, Naguti Priscilla, Basemera Miriam, Payne Beth A, Vidler Marianne, Singer Joel, McNair Avery, AboMoslim Maryam, Smith Laurie, Orem Jackson, Nakisige Carolyn, Ogilvie Gina
School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada.
Women's Health Research Institute, Vancouver, British Columbia, Canada.
PLOS Glob Public Health. 2024 Mar 15;4(3):e0002554. doi: 10.1371/journal.pgph.0002554. eCollection 2024.
There is limited research on how a cervical cancer diagnosis financially impacts women and their families in Uganda. This analysis aimed to describe the economic impact of cervical cancer treatment, including how it differs by socio-economic status (SES) in Uganda. We conducted a cross-sectional study from September 19, 2022 to January 17, 2023. Women were recruited from the Uganda Cancer Institute and Jinja Regional Referral Hospital, and were eligible if they were ≥ of 18 years and being treated for cervical cancer. Participants completed a survey that included questions about their out-of-pocket costs, unpaid labor, and family's economic situation. A wealth index was constructed to determine their SES. Descriptive statistics were reported. Of the 338 participants, 183 were from the lower SES. Women from the lower SES were significantly more likely to be older, have ≤ primary school education, and have a more advanced stage of cervical cancer. Over 90% of participants in both groups reported paying out-of-pocket for cervical cancer. Only 15 participants stopped treatment because they could not afford it. Women of a lower SES were significantly more likely to report borrowing money (higher SES n = 47, 30.5%; lower SES n = 84, 46.4%; p-value = 0.004) and selling possessions (higher SES n = 47, 30.5%; lower SES n = 90, 49.7%; p-value = 0.006) to pay for care. Both SES groups reported a decrease in the amount of time that they spent caring for their children since their cervical cancer diagnosis (higher SES n = 34, 31.2%; lower SES n = 36, 29.8%). Regardless of their SES, women in Uganda incur out-of-pocket costs related to their cervical cancer treatment. However, there are inequities as women from the lower SES groups were more likely to borrow funds to afford treatment. Alternative payment models and further economic support could help alleviate the financial burden of cervical cancer care in Uganda.
关于宫颈癌诊断对乌干达妇女及其家庭的经济影响，相关研究有限。本分析旨在描述宫颈癌治疗的经济影响，包括其在乌干达不同社会经济地位（SES）群体中的差异情况。我们于2022年9月19日至2023年1月17日开展了一项横断面研究。研究对象从乌干达癌症研究所和金贾地区转诊医院招募，年龄≥18岁且正在接受宫颈癌治疗的女性符合入选条件。参与者完成了一项调查，内容包括自付费用、无薪劳动以及家庭经济状况等问题。构建了一个财富指数以确定她们的社会经济地位，并报告了描述性统计数据。在338名参与者中，183人来自社会经济地位较低群体。社会经济地位较低的女性年龄更大、受教育程度≤小学且宫颈癌分期更晚的可能性显著更高。两组中超过90%的参与者报告为宫颈癌治疗支付了自付费用。只有15名参与者因负担不起而停止治疗。社会经济地位较低的女性报告借钱（社会经济地位较高组n = 47，30.5%；社会经济地位较低组n = 84，46.4%；p值 = 0.004）和出售财产（社会经济地位较高组n = 47，30.5%；社会经济地位较低组n = 90，49.7%；p值 = 0.006）以支付治疗费用的可能性显著更高。两个社会经济地位组均报告自诊断宫颈癌以来，她们照顾孩子的时间减少（社会经济地位较高组n = 34，31.2%；社会经济地位较低组n = 36，29.8%）。无论社会经济地位如何，乌干达的女性都要承担与宫颈癌治疗相关的自付费用。然而，存在不平等现象，因为社会经济地位较低群体的女性更有可能借钱来支付治疗费用。替代性支付模式和进一步的经济支持有助于减轻乌干达宫颈癌治疗的经济负担。
