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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, Knapp, Martin, McDaid, David, 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

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Identification Number: 10.1017/S0033291715000719

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
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: 20 Mar 2019 02:41
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

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