Men's health needs assessment in the Toledo District of Southern Belize

Belize is a small country in Central America with a growing burden of non-communicable disease (NCD), including hypertension and diabetes. Toledo District is the southernmost and poorest district in the country. Reliable national level health data for Belize is readily available, but the data is rarely disaggregated by sex or district. Reducing the burden of NCDs is a high priority for the Ministry of Health and Wellness. Belize's progress to date on Sustainable Development Goal (SDG) 3 (Good Health and Wellbeing) has been modest with many indicators stagnating or progress increasing at less than 50% of the required rate. SDG 3 describes the need to reduce the risks of NCDs and to strengthen the capacities of the healthcare workforce.

The objective was to perform a men's health needs assessment to identify and prioritize men's health needs in the Toledo District.

This was a mixed methods study. Qualitative data were collected from semi-structured interviews. Interviews were recorded, transcribed, and analyzed using Thematic Analysis. Quantitative data included epidemiological data from national vital statistics or disease registries and other public sources. Data were collected between January and June 2017.

Belizean men have among the highest risk for cardiac or diabetes related illness or death in the Americas. Diabetes and hypertension are responsible for 4.49% and 1.23% of Disability Adjusted Life Years in men respectively and are increasing by 2.51% annually. Fifty-seven interviews (55 individuals and two groups) from nine villages were carried out. Four themes emerged from the qualitative data. Men in Toledo: • have poor health literacy; • have reasonable access to health resources, but do not use them; • inability to clearly articulate health priorities; • do not process risk well.

Men in Toledo suffer from a high prevalence of NCDs including hypertension and diabetes and understand health and risks poorly. This may contribute to Belize's struggle to achieve the goals of SDG 3.4.1. Strengthening the healthcare workforce by improved training of community health workers (CHWs) and providing health education to men in Toledo is required to address these concerns.