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.