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Strengthening mental health system governance in six low- and middle-income countries in Africa and South Asia: challenges, needs and potential strategies

PETERSEN, Inge
et al
February 2017

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The aim of this study was to identify key governance issues that need to be addressed to facilitate the integration of mental health services into general health care in the six participating "Emerald" countries (Ethiopia, India, Nepal, Nigeria, South Africa, and Uganda).  The study adopted a descriptive qualitative approach, using framework analysis. Purposive sampling was used to recruit a range of key informants, to ensure views were elicited on all the governance issues within the expanded framework. Key informants across the six countries included policy makers at the national level in the Department/Ministry of Health; provincial coordinators and planners in primary health care and mental health; and district-level managers of primary and mental health care services. A total of 141 key informants were interviewed across the six countries. Data were transcribed (and where necessary, translated into English) and analysed thematically using framework analysis, first at the country level, then synthesised at a cross-country level.

Disease control priorities in developing countries. 2nd edition. Chapter 15. Cost-effectiveness analysis for priority setting.

MUSGROVE, Phillip
FOX-RUSHBY, Julia
2006

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What cost-effectiveness analysis (CEA) does and does not provide, how it is related to the concept of burden of disease, and how it can be used, along with other criteria, in setting priorities is discussed. The several meanings of the term CEA and the way that interventions are classified and evaluated are described. Estimating the effectiveness of an intervention requires specifying the units which in turn requires choices of several parameter values, including, in the analyses reported here, the discount rate applied to future years; the disability weights that describe the severity of diseases and conditions, corresponding to the health losses that they cause; and the life expectancy at different ages. Costs of interventions to include in the analysis, and conversion of costs to equivalents in U.S. dollars for international comparisons are described. Variations of results and uncertainty of estimates are discussed. Two ways are suggested to consider costs and outcomes at the population level, allowing for large differences among countries in the size of population; the incidence or prevalence of a disease, condition, or risk factor; and the amount spent or available to spend on an intervention

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