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dc.contributor.authorMcBain, Ryan Keniston
dc.contributor.authorNorton, Daniel J.
dc.contributor.authorMorris, Jodi
dc.contributor.authorYasamy, M. Taghi
dc.contributor.authorBetancourt, Theresa S.
dc.date.accessioned2012-04-20T19:09:21Z
dc.date.issued2012
dc.identifier.citationMcBain, Ryan Keniston, Daniel J. Norton, Jodi Morris, M. Taghi Yasamy, and Theresa S. Betancourt. 2012. The role of health systems factors in facilitating access to psychotropic medicines: A cross-sectional analysis of the WHO-AIMS in 63 low- and middle-income countries. PLoS Medicine 9(1): e1001166.en_US
dc.identifier.issn1549-1277en_US
dc.identifier.issn1549-1676en_US
dc.identifier.urihttp://nrs.harvard.edu/urn-3:HUL.InstRepos:8605328
dc.description.abstractBackground: Neuropsychiatric conditions comprise 14% of the global burden of disease and 30% of all noncommunicable disease. Despite the existence of cost-effective interventions, including administration of psychotropic medicines, the number of persons who remain untreated is as high as 85% in low- and middle-income countries (LAMICs). While access to psychotropic medicines varies substantially across countries, no studies to date have empirically investigated potential health systems factors underlying this issue. Methods and findings: This study uses a cross-sectional sample of 63 LAMICs and country regions to identify key health systems components associated with access to psychotropic medicines. Data from countries that completed the World Health Organization Assessment Instrument for Mental Health Systems (WHO-AIMS) were included in multiple regression analyses to investigate the role of five major mental health systems domains in shaping medicine availability and affordability. These domains are: mental health legislation, human rights implementations, mental health care financing, human resources, and the role of advocacy groups. Availability of psychotropic medicines was associated with features of all five mental health systems domains. Most notably, within the domain of mental health legislation, a comprehensive national mental health plan was associated with 15% greater availability; and in terms of advocacy groups, the participation of family-based organizations in the development of mental health legislation was associated with 17% greater availability. Only three measures were related with affordability of medicines to consumers: level of human resources, percentage of countries' health budget dedicated to mental health, and availability of mental health care in prisons. Controlling for country development, as measured by the Human Development Index, health systems features were associated with medicine availability but not affordability. Conclusions: Results suggest that strengthening particular facets of mental health systems might improve availability of psychotropic medicines and that overall country development is associated with affordability.en_US
dc.language.isoen_USen_US
dc.publisherPublic Library of Scienceen_US
dc.relation.isversionofdoi:10.1371/journal.pmed.1001166en_US
dc.relation.hasversionhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC3269418/en_US
dash.licenseLAA
dc.titleThe Role of Health Systems Factors in Facilitating Access to Psychotropic Medicines: A Cross-Sectional Analysis of the WHO-AIMS in 63 Low- and Middle-Income Countriesen_US
dc.typeJournal Articleen_US
dc.description.versionVersion of Recorden_US
dc.relation.journalPLoS Medicineen_US
dash.depositing.authorMcBain, Ryan Keniston
dc.date.available2012-04-20T19:09:21Z
dc.identifier.doi10.1371/journal.pmed.1001166*
dash.contributor.affiliatedMcBain, Ryan Keniston
dash.contributor.affiliatedBetancourt, Theresa


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