Estimating the cost of implementing district mental healthcare plans in five low- and middle-income countries: the PRIME study

Background: An essential element of mental health service scale up relates to an assessment of resource requirements and cost implications. Aims: To assess the expected resource needs of scaling up services in five districts in sub-Saharan Africa and south Asia. Method: The resource quantities associated with each site's specified care package were identified and subsequently costed, both at current and target levels of coverage. Results: The cost of the care package at target coverage ranged from US$0.21 to 0.56 per head of population in four of the districts (in the higher-income context of South Africa, it was US$1.86). In all districts, the additional amount needed each year to reach target coverage goals after 10 years was below $0.10 per head of population. Conclusions: Estimation of resource needs and costs for district-level mental health services provides relevant information concerning the financial feasibility of locally developed plans for successful scale up. This research is supported by the Department for International Development’s Programme for Improving Mental Health Care (PRIME) which is led by University of Cape Town