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

Author

Listed:
  • de Menil, Victoria
  • Knapp, Martin
  • McDaid, David
  • Raja, Shoba
  • Kingori, Joyce
  • Waruguru, Milka
  • Kippen Wood, Sarah
  • Mannarath, Saju
  • Lund, Crick

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.

Suggested Citation

  • de Menil, Victoria & Knapp, Martin & McDaid, David & Raja, Shoba & Kingori, Joyce & Waruguru, Milka & Kippen Wood, Sarah & Mannarath, Saju & Lund, Crick, 2015. "Cost-effectiveness of the mental health and development model for schizophrenia-spectrum and bipolar disorders in rural Kenya," LSE Research Online Documents on Economics 62040, London School of Economics and Political Science, LSE Library.
  • Handle: RePEc:ehl:lserod:62040
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    File URL: http://eprints.lse.ac.uk/62040/
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    References listed on IDEAS

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    1. Shoba Raja & Chris Underhill, 2012. "Integrating Mental Health and Development: A Case Study of the BasicNeeds Model in Nepal," Working Papers id:5110, eSocialSciences.
    2. Shoba Raja & Chris Underhill & Padam Shrestha & Uma Sunder & Saju Mannarath & Sarah Kippen Wood & Vikram Patel, 2012. "Integrating Mental Health and Development: A Case Study of the BasicNeeds Model in Nepal," PLOS Medicine, Public Library of Science, vol. 9(7), pages 1-7, July.
    3. Su, Tin Tin & Sanon, Mamadou & Flessa, Steffen, 2007. "Assessment of indirect cost-of-illness in a subsistence farming society by using different valuation methods," Health Policy, Elsevier, vol. 83(2-3), pages 353-362, October.
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    More about this item

    Keywords

    Africa; community mental health; economic outcomes; global mental health; severe mental disorders;
    All these keywords.

    JEL classification:

    • J1 - Labor and Demographic Economics - - Demographic Economics

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