Moving towards universal health coverage for mental disorders in Ethiopia

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dc.contributor.authorHanlon, Charlotte
dc.contributor.authorAlem, Atalay
dc.contributor.authorLund, Crick
dc.contributor.authorHailemariam, Damen
dc.contributor.authorAssefa, Esubalew
dc.contributor.authorGiorgis, Tedla W
dc.contributor.authorChisholm, Dan
dc.date.accessioned2019-03-07T07:45:18Z
dc.date.available2019-03-07T07:45:18Z
dc.date.issued2019-02-25
dc.date.updated2019-03-03T04:14:33Z
dc.description.abstractBackground People with mental disorders in low-income countries are at risk of being left behind during efforts to expand universal health coverage. Aims To propose context-relevant strategies for moving towards universal health coverage for people with mental disorders in Ethiopia. Methods We conducted a situational analysis to inform a SWOT analysis of coverage of mental health services and financial risk protection, health system characteristics and the macroeconomic and fiscal environment. In-depth interviews were conducted with five national experts on health financing and equity and analysed using a thematic approach. Findings from the situation analysis and qualitative study were used to develop recommended strategies for adequate, fair and sustainable financing of mental health care in Ethiopia. Results Opportunities for improved financing of mental health care identified from the situation analysis included: a significant mental health burden with evidence from strong local epidemiological data; political commitment to address that burden; a health system with mechanisms for integrating mental health into primary care; and a favourable macro-fiscal environment for investment in human capabilities. Balanced against this were constraints of low current general government health expenditure, low numbers of mental health specialists, weak capacity to plan and implement mental health programmes and low population demand for mental health care. All key informants referred to the under-investment in mental health care in Ethiopia. Respondents emphasised opportunities afforded by positive rates of economic growth in the country and the expansion of community-based health insurance, as well as the need to ensure full implementation of existing task-sharing programmes for mental health care, integrate mental health into other priority programmes and strengthen advocacy to ensure mental health is given due attention. Conclusion Expansion of public health insurance, leveraging resources from high-priority SDG-related programmes and implementing existing plans to support task-shared mental health care are key steps towards universal health coverage for mental disorders in Ethiopia. However, external donors also need to deliver on commitments to include mental health within development funding. Future researchers and planners can apply this approach to other countries of sub-Saharan Africa and identify common strategies for sustainable and equitable financing of mental health care.
dc.identifier.apacitationHanlon, C., Alem, A., Lund, C., Hailemariam, D., Assefa, E., Giorgis, T. W., & Chisholm, D. (2019). Moving towards universal health coverage for mental disorders in Ethiopia. <i>International Journal of Mental Health Systems</i>, http://hdl.handle.net/11427/29904en_ZA
dc.identifier.chicagocitationHanlon, Charlotte, Atalay Alem, Crick Lund, Damen Hailemariam, Esubalew Assefa, Tedla W Giorgis, and Dan Chisholm "Moving towards universal health coverage for mental disorders in Ethiopia." <i>International Journal of Mental Health Systems</i> (2019) http://hdl.handle.net/11427/29904en_ZA
dc.identifier.citationHanlon, C., Alem, A., Lund, C., Hailemariam, D., Assefa, E., Giorgis, T. W., & Chisholm, D. (2019). Moving towards universal health coverage for mental disorders in Ethiopia. International Journal of Mental Health Systems, 13(1), 11.
dc.identifier.ris TY - Journal Article AU - Hanlon, Charlotte AU - Alem, Atalay AU - Lund, Crick AU - Hailemariam, Damen AU - Assefa, Esubalew AU - Giorgis, Tedla W AU - Chisholm, Dan AB - Background People with mental disorders in low-income countries are at risk of being left behind during efforts to expand universal health coverage. Aims To propose context-relevant strategies for moving towards universal health coverage for people with mental disorders in Ethiopia. Methods We conducted a situational analysis to inform a SWOT analysis of coverage of mental health services and financial risk protection, health system characteristics and the macroeconomic and fiscal environment. In-depth interviews were conducted with five national experts on health financing and equity and analysed using a thematic approach. Findings from the situation analysis and qualitative study were used to develop recommended strategies for adequate, fair and sustainable financing of mental health care in Ethiopia. Results Opportunities for improved financing of mental health care identified from the situation analysis included: a significant mental health burden with evidence from strong local epidemiological data; political commitment to address that burden; a health system with mechanisms for integrating mental health into primary care; and a favourable macro-fiscal environment for investment in human capabilities. Balanced against this were constraints of low current general government health expenditure, low numbers of mental health specialists, weak capacity to plan and implement mental health programmes and low population demand for mental health care. All key informants referred to the under-investment in mental health care in Ethiopia. Respondents emphasised opportunities afforded by positive rates of economic growth in the country and the expansion of community-based health insurance, as well as the need to ensure full implementation of existing task-sharing programmes for mental health care, integrate mental health into other priority programmes and strengthen advocacy to ensure mental health is given due attention. Conclusion Expansion of public health insurance, leveraging resources from high-priority SDG-related programmes and implementing existing plans to support task-shared mental health care are key steps towards universal health coverage for mental disorders in Ethiopia. However, external donors also need to deliver on commitments to include mental health within development funding. Future researchers and planners can apply this approach to other countries of sub-Saharan Africa and identify common strategies for sustainable and equitable financing of mental health care. DA - 2019-02-25 DB - OpenUCT DP - University of Cape Town J1 - International Journal of Mental Health Systems LK - https://open.uct.ac.za PY - 2019 T1 - Moving towards universal health coverage for mental disorders in Ethiopia TI - Moving towards universal health coverage for mental disorders in Ethiopia UR - http://hdl.handle.net/11427/29904 ER - en_ZA
dc.identifier.urihttps://doi.org/10.1186/s13033-019-0268-9
dc.identifier.urihttp://hdl.handle.net/11427/29904
dc.identifier.vancouvercitationHanlon C, Alem A, Lund C, Hailemariam D, Assefa E, Giorgis TW, et al. Moving towards universal health coverage for mental disorders in Ethiopia. International Journal of Mental Health Systems. 2019; http://hdl.handle.net/11427/29904.en_ZA
dc.language.isoen
dc.publisherBioMed Central
dc.rights.holderThe Author(s)
dc.sourceInternational Journal of Mental Health Systems
dc.source.urihttps://ijmhs.biomedcentral.com/
dc.subject.otherUniversal health coverage
dc.subject.otherHealth financing
dc.subject.otherMental health
dc.subject.otherMental disorders
dc.subject.otherFinancial coverage
dc.subject.otherHealth insurance
dc.subject.otherEthiopia
dc.subject.otherHealth expenditure
dc.subject.otherSub-Saharan Africa
dc.titleMoving towards universal health coverage for mental disorders in Ethiopia
dc.typeJournal Article
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