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International Journal of Mental Health Systems

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Open Access 01-12-2019 | Care | Research

Moving towards universal health coverage for mental disorders in Ethiopia

Authors: Charlotte Hanlon, Atalay Alem, Crick Lund, Damen Hailemariam, Esubalew Assefa, Tedla W. Giorgis, Dan Chisholm

Published in: International Journal of Mental Health Systems | Issue 1/2019

Abstract

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.

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Title: Moving towards universal health coverage for mental disorders in Ethiopia
Authors: Charlotte Hanlon
Atalay Alem
Crick Lund
Damen Hailemariam
Esubalew Assefa
Tedla W. Giorgis
Dan Chisholm
Publication date: 01-12-2019
Publisher: BioMed Central
Keyword: Care
Published in: International Journal of Mental Health Systems / Issue 1/2019
Electronic ISSN: 1752-4458
DOI: https://doi.org/10.1186/s13033-019-0268-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Moving towards universal health coverage for mental disorders in Ethiopia

Abstract

Background

Aims

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Aims

Methods

Results

Conclusion

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