Incontinence Everyone's Problem

Urinary Incontinence in New Zealand - Everyone's Problem

Urinary incontinence has recently been identified by the World Health Organisation as a major health issue in developed and developing nations. An international consultation was held in Monaco in 1998 has produced an internationally accepted consensus statement on urinary incontinence.

New Zealand needs to take action to address this health issue.

Urinary incontinence affects all age groups. Urinary incontinence is an important problem in children. This is a problem so common it is given its own name, enuresis. Excellent New Zealand information gives the prevalence of nocturnal enuresis of around 13% of children between age 5 and 10 and 5% of children between the age of 11 and 15. Based on the 1996 Census over 50,000 children over the age of 5 have nocturnal enuresis.

Urinary incontinence is also very common in women with excellent New Zealand information to show that 17% of adult women have bothersome urinary incontinence. Based on the 1996 Census over 180,000 women have bothersome urinary incontinence. The prevalence is even higher in adult Maori women at 47%. Only a small proportion of women with urinary incontinence seek health professional assistance and Maori women in particular do not seek health care assistance. A small proportion of adult men have urinary incontinence but this still represents 20,000 people.

Urinary incontinence affects all age groups.

A face to face survey of older residents in Gisborne found that 7.4% of people over age 65 had urinary incontinence more than two to three times a week or had an indwelling urethral catheter. Based on the 1996 Census over 31,000 New Zealanders over the age of 65 have severe urinary incontinence. In New Zealand the survey information published in 'Disability Counts' by Statistics New Zealand showed that of 27,600 people over the age of 15 living in residential care 10,300, or 37% use continence products. 87% of these people were over the age of 65. A report on all residents in institutional care in Auckland in 1993 demonstrated that 47% had urinary incontinence. Based on the 1996 Census over 11,000 people resident in care have urinary incontinence. In 1997/98 the Health Funding Authority spent 387 Million dollars on residential care subsidies.

For Maori and Muslim women strong cultural taboos make seeking access to health care even more difficult.

Urinary incontinence is not a lethal condition but it is certainly not a glamorous one. It is strongly associated with poor quality of life and self esteem, social isolation and depression. Women with urinary incontinence avoid sex.

Current services in New Zealand are inadequate, inequitable and fragmented. The New Zealand Continence Association is conducting a sample survey of current services. There are no national written standards for continence services in New Zealand. Health professionals feel they have inadequate training in the assessment and management of urinary incontinence. The financial cost for urinary incontinence has been estimated at 3,565 US dollars per year per person.

The New Zealand Continence Association has been promoting public awareness of urinary incontinence in New Zealand for a number of years. The New Zealand Continence Association strongly believes now is the time for health agencies, and in particular the Health Funding Authority, to develop a national strategy to address this health problem that affects at least 600,000 New Zealanders.

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