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Cost-effectiveness of the mental health and development model for schizophrenia-spectrum and bipolar disorders in rural Kenya

de Menil, Victoria and Knapp, Martin and McDaid, David and Raja, Shoba and Kingori, Joyce and Waruguru, Milka and Kippen Wood, Sarah and 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

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Identification Number: 10.1017/S0033291715000719


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:
Additional Information: © 2015 Cambridge University Press
Divisions: Social Policy
Personal Social Services Research Unit
Subjects: H Social Sciences > HB Economic Theory
R Medicine > RC Internal medicine
Sets: Departments > Social Policy
Research centres and groups > Personal Social Services Research Unit (PSSRU)
Date Deposited: 22 May 2015 09:21
Last Modified: 04 Dec 2015 10:56
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

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