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Household economic costs associated with mental, neurological and substance use disorders: a cross-sectional survey in six low- and middle-income countries

  • Crick Lund (a1), Sumaiyah Docrat (a2), Jibril Abdulmalik (a3), Atalay Alem (a4), Abebaw Fekadu (a5), Oye Gureje (a6), Dristy Gurung (a7), Damen Hailemariam (a8), Yohannes Hailemichael (a9), Charlotte Hanlon (a10), Mark J. D. Jordans (a11), Dorothy Kizza (a12), Sharmishtha Nanda (a13), Saheed Olayiwola (a14), Rahul Shidhaye (a15), Nawaraj Upadhaya (a16), Graham Thornicroft (a17) and Dan Chisholm (a18)...

Abstract

Background

Little is known about the household economic costs associated with mental, neurological and substance use (MNS) disorders in low- and middle-income countries.

Aims

To assess the association between MNS disorders and household education, consumption, production, assets and financial coping strategies in Ethiopia, India, Nepal, Nigeria, South Africa and Uganda.

Method

We conducted an exploratory cross-sectional household survey in one district in each country, comparing the economic circumstances of households with an MNS disorder (alcohol-use disorder, depression, epilepsy or psychosis) (n = 2339) and control households (n = 1982).

Results

Despite some heterogeneity between MNS disorder groups and countries, households with a member with an MNS disorder had generally lower levels of adult education; lower housing standards, total household income, effective income and non-health consumption; less asset-based wealth; higher healthcare expenditure; and greater use of deleterious financial coping strategies.

Conclusions

Households living with a member who has an MNS disorder constitute an economically vulnerable group who are susceptible to chronic poverty and intergenerational poverty transmission.

Declaration of interest

D.C. is a staff member of the World Health Organization. The authors alone are responsible for the views expressed in this publication and they do not necessarily represent the decisions, policy or views of the World Health Organization.

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Copyright

This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is unaltered and is properly cited. The written permission of Cambridge University Press must be obtained for commercial re-use or in order to create a derivative work.

Corresponding author

Correspondence: Crick Lund, Alan J. Flisher, Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, 46 Sawkins Road, Rondebosch, 7700, Cape Town, South Africa. Email: crick.lund@uct.ac.za

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Household economic costs associated with mental, neurological and substance use disorders: a cross-sectional survey in six low- and middle-income countries

  • Crick Lund (a1), Sumaiyah Docrat (a2), Jibril Abdulmalik (a3), Atalay Alem (a4), Abebaw Fekadu (a5), Oye Gureje (a6), Dristy Gurung (a7), Damen Hailemariam (a8), Yohannes Hailemichael (a9), Charlotte Hanlon (a10), Mark J. D. Jordans (a11), Dorothy Kizza (a12), Sharmishtha Nanda (a13), Saheed Olayiwola (a14), Rahul Shidhaye (a15), Nawaraj Upadhaya (a16), Graham Thornicroft (a17) and Dan Chisholm (a18)...
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