Mental health financing challenges, opportunities and strategies in low- and middle-income countries: findings from the Emerald project
Year: 2019
Type: article
Abstract: BACKGROUND: Current coverage of mental healthcare in low- and middle-income countries is very limited, not only in terms of access to services but also in terms of financial protection of individuals in need of care and treatment. AIMS: To identify the challenges, opportunities and strategies for more equitable and sustainable mental health financing in six sub-Saharan African and South Asian countries, namely Ethiopia, India, Nepal, Nigeria, South Africa and Uganda. METHOD: In the context of a mental health systems research project (Emerald), a multi-methods approach was implemented consisting of three steps: a quantitative and narrative assessment of each country's disease burden profile, health system and macro-fiscal situation; in-depth interviews with expert stakeholders; and a policy analysis of sustainable financing options. RESULTS: Key challenges identified for sustainable mental health financing include the low level of funding accorded to mental health services, widespread inequalities in access and poverty, although opportunities exist in the form of new political interest in mental health and ongoing reforms to national insurance schemes. Inclusion of mental health within planned or nascent national health insurance schemes was identified as a key strategy for moving towards more equitable and sustainable mental health financing in all six countries. CONCLUSIONS: Including mental health in ongoing national health insurance reforms represent the most important strategic opportunity in the six participating countries to secure enhanced service provision and financial protection for individuals and households affected by mental disorders and psychosocial disabilities. DECLARATION OF INTEREST: D.C. is a staff member of the World Health Organization.
Source: BJPsych Open
DOI: 10.1192/bjo.2019.24
Institutions: World Health Organization, University of Cape Town, Alan J Flisher Centre for Public Mental Health, University of Ibadan, Addis Ababa University, Stellenbosch University, King's College London, Butabika Hospital, Public Health Foundation of India, Federal University of Technology, Maastricht University, Care and Public Health Research Institute
Language: English
Subfield: Finance
Domain: Social Sciences
Open Access status: gold
Estimated APC paid: $1,600
Funders: World Health Organization, Government of the United Kingdom, National Institute for Health and Care Research, Department of Health and Social Care, Department for International Development, UK Government, King's College London, European Commission, South African Medical Research Council, Department for International Development, University of Cape Town, National Institutes of Health, Medical Research Council, National Institute of Mental Health
Awards: G1093531541, G1675507368, G2224893290, G245032056, G2473961061, G2577021683, G2685147384, G2862574360, G2973790809, Indigo (International study of discrimination and stigma outcomes), G3207356259, E-MhGAP Intervention guide in Low and middle income countries: proof-of-concept for Impact and Acceptability (Emilia project), G3792107920, G393177772, NIHR Global Health Research Unit on Health System Strengthening in Sub-Saharan Africa, King's College London, G4053596972, G40759040, COBALT: Comorbid Affective Disorders, AIDS/HIV, and Long Term Health, G5073455505, Emerging mental health systems in low- and middle-income countries, G5702163051, G7311574907
OpenAlex ID: W4243586056