Sustainable financing mechanisms for strengthening mental health systems in Nigeria

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dc.contributor.authorAbdulmalik, Jibril
dc.contributor.authorOlayiwola, Saheed
dc.contributor.authorDocrat, Sumaiyah
dc.contributor.authorLund, Crick
dc.contributor.authorChisholm, Dan
dc.contributor.authorGureje, Oye
dc.date.accessioned2019-07-02T10:55:47Z
dc.date.available2019-07-02T10:55:47Z
dc.date.issued2019-05-31
dc.date.updated2019-06-02T06:22:56Z
dc.description.abstractBackground and aims Current coverage of mental health care in low- and middle-income countries is limited, not only in terms of access to services but also in terms of financial protection of persons in need of care and treatment. This is especially pertinent considering the established relationship between mental illness and poverty and the need to ensure the financial risk protection of persons with mental disorders and their families as part of country’s efforts to attain universal health coverage. This study set out to review the health and socio-economic contexts of Nigeria as well as to generate strategies for sustainable mental health financing that will be feasible, within the specific context of the country. Methods A multi-methods approach was developed and applied, consisting of three steps: a situational analysis of Nigeria’s health system, macro-fiscal economic profile, and socio-political status, including a strengths, weaknesses, opportunities and threats (SWOT) analysis of the Nigerian socio-economic, general and mental health context; key informant interviews with 12 expert stakeholders drawn from state and non-state actors in the health and financial sectors; and a policy analysis of sustainable financing options. Results Key challenges identified were: poor funding; reduced access to care, resulting in a huge treatment gap; and out of pocket payment for services—leading to impoverishment. Comprehensive coverage of mental health conditions within the ongoing health insurance reforms was identified as a key strategy for moving towards sustainable mental health financing in Nigeria. Other identified strategies include enhanced integration of mental health into primary care; incorporation of mental health into other strategic and currently funded programmes; adoption of performance-based financing measures; and renewed engagement with stakeholders, including external donor institutions. Conclusions A suite of feasible and actionable measures can be implemented to increase mental health service financing, reduce health-related financial burden on households, increase help-seeking and access to quality mental health care and, ultimately, reduce the large treatment and financing gap for mental disorders in Nigeria.
dc.identifier.apacitationAbdulmalik, J., Olayiwola, S., Docrat, S., Lund, C., Chisholm, D., & Gureje, O. (2019). Sustainable financing mechanisms for strengthening mental health systems in Nigeria. <i>International journal of mental health systems</i>, http://hdl.handle.net/11427/30277en_ZA
dc.identifier.chicagocitationAbdulmalik, Jibril, Saheed Olayiwola, Sumaiyah Docrat, Crick Lund, Dan Chisholm, and Oye Gureje "Sustainable financing mechanisms for strengthening mental health systems in Nigeria." <i>International journal of mental health systems</i> (2019) http://hdl.handle.net/11427/30277en_ZA
dc.identifier.citationAbdulmalik, J., Olayiwola, S., Docrat, S., Lund, C., Chisholm, D., & Gureje, O. (2019). Sustainable financing mechanisms for strengthening mental health systems in Nigeria. International journal of mental health systems.13(1): 38.
dc.identifier.ris TY - AU - Abdulmalik, Jibril AU - Olayiwola, Saheed AU - Docrat, Sumaiyah AU - Lund, Crick AU - Chisholm, Dan AU - Gureje, Oye AB - Background and aims Current coverage of mental health care in low- and middle-income countries is limited, not only in terms of access to services but also in terms of financial protection of persons in need of care and treatment. This is especially pertinent considering the established relationship between mental illness and poverty and the need to ensure the financial risk protection of persons with mental disorders and their families as part of country’s efforts to attain universal health coverage. This study set out to review the health and socio-economic contexts of Nigeria as well as to generate strategies for sustainable mental health financing that will be feasible, within the specific context of the country. Methods A multi-methods approach was developed and applied, consisting of three steps: a situational analysis of Nigeria’s health system, macro-fiscal economic profile, and socio-political status, including a strengths, weaknesses, opportunities and threats (SWOT) analysis of the Nigerian socio-economic, general and mental health context; key informant interviews with 12 expert stakeholders drawn from state and non-state actors in the health and financial sectors; and a policy analysis of sustainable financing options. Results Key challenges identified were: poor funding; reduced access to care, resulting in a huge treatment gap; and out of pocket payment for services—leading to impoverishment. Comprehensive coverage of mental health conditions within the ongoing health insurance reforms was identified as a key strategy for moving towards sustainable mental health financing in Nigeria. Other identified strategies include enhanced integration of mental health into primary care; incorporation of mental health into other strategic and currently funded programmes; adoption of performance-based financing measures; and renewed engagement with stakeholders, including external donor institutions. Conclusions A suite of feasible and actionable measures can be implemented to increase mental health service financing, reduce health-related financial burden on households, increase help-seeking and access to quality mental health care and, ultimately, reduce the large treatment and financing gap for mental disorders in Nigeria. DA - 2019-05-31 DB - OpenUCT DP - University of Cape Town J1 - International journal of mental health systems KW - Mental health financing KW - Nigeria KW - Mental health systems KW - Low income countries KW - Global mental health LK - https://open.uct.ac.za PY - 2019 T1 - Sustainable financing mechanisms for strengthening mental health systems in Nigeria TI - Sustainable financing mechanisms for strengthening mental health systems in Nigeria UR - http://hdl.handle.net/11427/30277 ER - en_ZA
dc.identifier.urihttps://doi.org/10.1186/s13033-019-0293-8
dc.identifier.urihttp://hdl.handle.net/11427/30277
dc.identifier.vancouvercitationAbdulmalik J, Olayiwola S, Docrat S, Lund C, Chisholm D, Gureje O. Sustainable financing mechanisms for strengthening mental health systems in Nigeria. International journal of mental health systems. 2019; http://hdl.handle.net/11427/30277.en_ZA
dc.language.rfc3066en
dc.rights.holderThe Author(s)
dc.sourceInternational journal of mental health systems
dc.source.urihttps://ijmhs.biomedcentral.com/
dc.subjectMental health financing
dc.subjectNigeria
dc.subjectMental health systems
dc.subjectLow income countries
dc.subjectGlobal mental health
dc.titleSustainable financing mechanisms for strengthening mental health systems in Nigeria
dc.typeJournal Article
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