Sustainable financing mechanisms for strengthening mental health systems in Nigeria
Abstract 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 rel...
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| Format: | Article |
| Language: | English |
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BMC
2019-05-01
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| Series: | International Journal of Mental Health Systems |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13033-019-0293-8 |
| _version_ | 1819064940822003712 |
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| author | Jibril Abdulmalik Saheed Olayiwola Sumaiyah Docrat Crick Lund Dan Chisholm Oye Gureje |
| author_facet | Jibril Abdulmalik Saheed Olayiwola Sumaiyah Docrat Crick Lund Dan Chisholm Oye Gureje |
| author_sort | Jibril Abdulmalik |
| collection | DOAJ |
| description | Abstract 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. |
| first_indexed | 2024-12-21T15:38:33Z |
| format | Article |
| id | doaj.art-731fd8fc7061457ea15408dd63589167 |
| institution | Directory Open Access Journal |
| issn | 1752-4458 |
| language | English |
| last_indexed | 2024-12-21T15:38:33Z |
| publishDate | 2019-05-01 |
| publisher | BMC |
| record_format | Article |
| series | International Journal of Mental Health Systems |
| spelling | doaj.art-731fd8fc7061457ea15408dd635891672022-12-21T18:58:34ZengBMCInternational Journal of Mental Health Systems1752-44582019-05-0113111510.1186/s13033-019-0293-8Sustainable financing mechanisms for strengthening mental health systems in NigeriaJibril Abdulmalik0Saheed Olayiwola1Sumaiyah Docrat2Crick Lund3Dan Chisholm4Oye Gureje5Department of Psychiatry, College of Medicine, University of IbadanDepartment of Economics, Federal University of TechnologyAlan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape TownAlan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape TownDepartment of Mental Health and Substance Abuse, World Health OrganizationDepartment of Psychiatry, College of Medicine, University of IbadanAbstract 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.http://link.springer.com/article/10.1186/s13033-019-0293-8Mental health financingNigeriaMental health systemsLow income countriesGlobal mental health |
| spellingShingle | Jibril Abdulmalik Saheed Olayiwola Sumaiyah Docrat Crick Lund Dan Chisholm Oye Gureje Sustainable financing mechanisms for strengthening mental health systems in Nigeria International Journal of Mental Health Systems Mental health financing Nigeria Mental health systems Low income countries Global mental health |
| title | Sustainable financing mechanisms for strengthening mental health systems in Nigeria |
| title_full | Sustainable financing mechanisms for strengthening mental health systems in Nigeria |
| title_fullStr | Sustainable financing mechanisms for strengthening mental health systems in Nigeria |
| title_full_unstemmed | Sustainable financing mechanisms for strengthening mental health systems in Nigeria |
| title_short | Sustainable financing mechanisms for strengthening mental health systems in Nigeria |
| title_sort | sustainable financing mechanisms for strengthening mental health systems in nigeria |
| topic | Mental health financing Nigeria Mental health systems Low income countries Global mental health |
| url | http://link.springer.com/article/10.1186/s13033-019-0293-8 |
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