Hostname: page-component-8448b6f56d-xtgtn Total loading time: 0 Render date: 2024-04-19T22:58:56.325Z Has data issue: false hasContentIssue false
  • English
  • Français

Estimating the cost of implementing district mental healthcare plans in five low- and middle-income countries: The PRIME study

Published online by Cambridge University Press:  02 January 2018

Dan Chisholm ,
Soumitra Burman-Roy ,
Abebaw Fekadu ,
Tasneem Kathree ,
Dorothy Kizza ,
Nagendra P. Luitel ,
Inge Petersen ,
Rahul Shidhaye ,
Mary De Silva  and
Crick Lund
Dan Chisholm*
Affiliation:
Department of Mental Health and Substance Abuse, World Health Organization, Geneva, Switzerland
Soumitra Burman-Roy
Affiliation:
Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, London, UK
Abebaw Fekadu
Affiliation:
Department of Psychiatry, Addis Ababa University, Ethiopia
Tasneem Kathree
Affiliation:
University of KwaZulu Natal, Durban, South Africa
Dorothy Kizza
Affiliation:
Butabika Mental Hospital, Kampala, Uganda
Nagendra P. Luitel
Affiliation:
Transcultural Psychosocial Organization (TPO) Nepal, Kathmandu, Nepal
Inge Petersen
Affiliation:
University of KwaZulu Natal, Durban, South Africa
Rahul Shidhaye
Affiliation:
Public Health Foundation of India, Bhopal, Madhya Pradesh, Delhi, India
Mary De Silva
Affiliation:
Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, London, UK
Crick Lund
Affiliation:
Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa, and Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
*
Dan Chisholm, Department of Mental Health and Substance Abuse, World Health Organization, 1211 Geneva, Switzerland. Email: chisholmd@who.int
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
Background

An essential element of mental health service scale up relates to an assessment of resource requirements and cost implications.

Aims

To assess the expected resource needs of scaling up services in five districts in sub-Saharan Africa and south Asia.

Method

The resource quantities associated with each site's specified care package were identified and subsequently costed, both at current and target levels of coverage.

Results

The cost of the care package at target coverage ranged from US$0.21 to 0.56 per head of population in four of the districts (in the higher-income context of South Africa, it was US$1.86). In all districts, the additional amount needed each year to reach target coverage goals after 10 years was below $0.10 per head of population.

Conclusions

Estimation of resource needs and costs for district-level mental health services provides relevant information concerning the financial feasibility of locally developed plans for successful scale up.

Type
Papers
Information
The British Journal of Psychiatry , Volume 208 , Issue s56: Mental health plans in five low- and middle-income countries: PRogramme for Improving Mental health carE (PRIME) , January 2016 , pp. s71 - s78
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) licence.
Copyright
Copyright © Royal College of Psychiatrists, 2016

Footnotes

This paper was produced as part of PRIME funded by UK aid from the UK government. However, the views expressed do not necessarily reflect the UK government's official policies.

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.

References

1 World Health Organization. Planning and Budgeting to Deliver Service for Mental Health. Mental Health Policy and Service Guidance Package. WHO, 2003.Google Scholar
2 Chisholm, D, Lund, C, Saxena, S. Cost of scaling up mental healthcare in low-and middle-income countries. Br J Psychiatry 2007; 191: 528–35.CrossRefGoogle ScholarPubMed
3 Lund, C, Tomlinson, M, De Silva, M, Fekadu, A, Shidhaye, R, Jordans, M, et al. PRIME: a programme to reduce the treatment gap for mental disorders in five low- and middle-income countries. PLoS Med 2012; 9: e1001359.Google Scholar
4 Hanlon, C, Luitel, NP, Kathree, T, Murhar, V, Shrivasta, S, Medhin, G, et al. Challenges and opportunities for implementing integrated mental health care: a district level situation analysis from five low- and middle-income countries. PLoS One 2014; 9: e88437.CrossRefGoogle ScholarPubMed
5 Fekadu, A, Hanlon, C, Medhin, G, Alem, A, Selamu, M, Giorgis, TW, et al. Development of a scalable mental healthcare plan for a rural district in Ethiopia. Br J Psychiatry 2015, in press (doi: 10.1192/bjp.bp.114.153676).Google Scholar
6 Jordans, MJD, Luitel, NP, Pokhrel, P, Patel, V. Development and pilot testing of a mental healthcare plan in Nepal. Br J Psychiatry 2015, in press (doi: 10.1192/bjp.bp.114.153718).Google Scholar
7 Kigozi, NF, Kizza, D, Nakku, J, Ssebunnya, J, Ndyanabangi, S, Nakiganda, B, et al. Development of a district mental healthcare plan in Uganda. Br J Psychiatry 2015, in press (doi: 10.1192/bjp.bp.114.153742).Google Scholar
8 Petersen, I, Fairall, L, Bhana, A, Kathree, T, Selohilwe, O, Brooke-Sumner, C, et al. Integrating mental health into chronic care in South Africa: the development of a district mental healthcare plan. Br J Psychiatry 2015, in press (doi: 10.1192/bjp.bp.114.153726).Google Scholar
9 Shidhaye, R, Shrivastava, S, Murhar, V, Samudre, S, Ahuja, S, Ramaswamy, R, et al. Development and piloting of a plan for integrating mental health in primary care in Sehore district, Madhya Pradesh, India. Br J Psychiatry 2015, in press (doi: 10.1192/bjp.bp.114.153700).CrossRefGoogle Scholar
10 World Health Organization. mhGAP Intervention Guide for Mental, Neurological and Substance Use Disorders in Non-Specialized Health Settings. WHO, 2010.Google Scholar
11 World Health Organization. Scaling Up Action Against Noncommunicable Diseases: How Much Will it Cost? WHO, 2011.Google Scholar
12 Chisholm, D, Saxena, S. Cost effectiveness of strategies to combat neuropsychiatric conditions in sub-Saharan Africa and South East Asia: mathematical modelling study. BMJ 2012; 344: e609.Google Scholar
13 Buttorff, C, Hock, R, Weiss, H, Naik, S, Araya, R, Kirkwood, B, et al. Economic evaluation of a task-shifting intervention for common mental disorders in India. Bull World Health Organ 2012; 90: 813–21.Google Scholar
14 Gureje, O, Chisholm, D, Kola, L, Lasebikan, V, Saxena, S. Cost-effectiveness of an essential mental health intervention package in Nigeria. World Psychiatry 2007; 6: 42–8.Google Scholar
15 Lidner, LM, Marasciulo, AC, Garias, MR, Grohs, GEM. Economic evaluation of antipychotic drugs for schizophrenia treatment within the Brazilian healthcare system. Rev Saude Publica 2009; 43 (suppl 1): 1–7.Google Scholar
16 Phanthunane, P, Vos, T, Whiteford, H, Bertram, M. Cost-effectiveness of pharmacological and psychosocial interventions for schizophrenia. Cost Eff Resour Alloc 2011; 9: 6.Google Scholar
Supplementary material: PDF

Chisholm et al. supplementary material

Supplementary Table S1

Download Chisholm et al. supplementary material(PDF)
PDF 32.4 KB
Submit a response

eLetters

No eLetters have been published for this article.