de Menil, Victoria, Knapp, Martin ORCID: 0000-0003-1427-0215, McDaid, David ORCID: 0000-0003-0744-2664, Raja, Shoba, Kingori, Joyce, Waruguru, Milka, Kippen Wood, Sarah, Mannarath, Saju and Lund, Crick (2015) Cost-effectiveness of the mental health and development model for schizophrenia-spectrum and bipolar disorders in rural Kenya. Psychological Medicine, 45 (12). pp. 2747-2756. ISSN 0033-2917
|
PDF
Download (743kB) | Preview |
Abstract
Background. The treatment gap for serious mental disorders across low-income countries is estimated to be 89%. The model for Mental Health and Development (MHD) offers community-based care for people with mental disorders in eleven low- and middle-income countries. Methods. In Kenya, using a pre-post design, 117 consecutively enrolled participants with schizophrenia-spectrum and bipolar disorders were followed-up at 10 and 20 months. Comparison outcomes were drawn from the literature. Costs were analysed from societal and health system perspectives. Results. From the societal perspective, MHD cost Int$ 594 per person in the first year and Int$ 876 over two years. The cost per healthy day gained was Int$ 7.96 in the first year and Int$ 1.03 over two years – less than the agricultural minimum wage. The cost per DALY averted over two years was Int$ 13.1 and Int$ 727 from the societal and health system perspectives, respectively – on par with antiretrovirals for HIV. Conclusions. MHD achieved increasing returns over time. The model appears cost-effective and equitable, especially over two-years. Its affordability relies on multi-sectoral participation nationally and internationally.
Item Type: | Article |
---|---|
Official URL: | http://journals.cambridge.org |
Additional Information: | © 2015 Cambridge University Press |
Divisions: | Social Policy Care Policy and Evaluation Centre |
Subjects: | H Social Sciences > HB Economic Theory R Medicine > RC Internal medicine |
Date Deposited: | 22 May 2015 09:21 |
Last Modified: | 14 Sep 2024 06:47 |
Projects: | DCI - NSAPVD/2008/156 - 918 [European Commission], CSCF 450 [UK Department for International Development] |
Funders: | European Commission Non-State Actor Funding Stream, UK Department for International Development Civil Society Challenge Fund |
URI: | http://eprints.lse.ac.uk/id/eprint/62040 |
Actions (login required)
View Item |