Universal Health Coverage for Mental, Neurological and Substance Use Disorders: An Extended Cost-Effectiveness Analysis

Authors: Dan Chisholm, Kjell Arne Johansson, Neha Raykar , Itamar Megiddo, Aditi Nigam, Kristen Bjerkreim Strand, Abigail Colson, Abebaw Fekadu, Stéphane Verguet


Equity and financial protection are important attributes of health systems, and this chapter uses case studies from India and Ethiopia to analyze epilepsy, schizophrenia, and depression. In India, there is a strong push toward universal public finance (UPF) to reverse decades of high, often impoverishing out-of-pocket (OOP) health care expenditures and to allocate resources more equitably. Ethiopia is one of many low-income countries in Sub-Saharan Africa facing a severe shortage of skilled workers and other resources for addressing the burden of mental, neurological, and substance use (MNS) disorders. The Ethiopian government has launched a National Mental Health Strategy which explicitly recognizes the importance of an efficient, equitable scale-up of mental health care within a broader, ongoing effort to increase levels of health insurance in the general population. The analyses show that enhanced coverage of effective treatment leads to significant improvements in population health and that this can be achieved at a very reasonable cost.


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