Page 29 - GHES-3-2

Global Health Economics and
Sustainability

PERSPECTIVE ARTICLE
Achieving universal health coverage in

Sub-Saharan Africa through the reformation of
mental health financing

1,2
Emmanuel Otieno * , Tabeta Seeiso 3 , Jeninah Businge 1 , Grace Kimera 4 ,
and Edward Sempira 5
1 Department of Health Economics, School of Public Health, Gudie University Project, Kampala,
Uganda
2 Chieftaincy of Medical Services, Uganda Peoples’ Defence Forces, Kampala, Uganda
3 Department of Nursing, Scott College of Nursing, Maseru, Lesotho
4 Department of Counseling and Addiction, Life Back Foundation Uganda, Kampala, Uganda
5 Department of Clinical Psychiatry, Life Back Foundation Uganda, Kampala, Uganda

Academic editor:
Mihajlo Jakovljevic M.D. Ph.D. MAE
Abstract
*Corresponding author:
Emmanuel Otieno Insufficient financing is limiting mental health services for universal health coverage
(otienomdc@gmail.com)
(UHC) in sub-Saharan Africa (SSA). Without ambitious steps to enhance mental
Citation: Otieno, E., Seeiso, T., health services, UHC will fall far below its historical agenda; however, adequate
Businge, J., Kimera, G., &
Sempira, E. (2025). Achieving mental health financing could strengthen governments’ capacity to provide
universal health coverage in additional budgetary resources. This paper aims to identify potential strategies for
Sub-Saharan Africa through the more equitable and sustainable mental health financing in SSA. Using Uganda as a
reformation of mental health
financing. Global Health Econ key example, we provide a contextual analysis and highlight current gaps. We draw
Sustain, 3(2):21-27. parallels with successful countries and discuss recommendations for engagement
https://doi.org/10.36922/ghes.3700 from the global mental health community. This perspective focuses on health
Received: May 20, 2024 systems, mental disease burden, and macro-fiscal situation. Drivers of fiscal space
for health indicate prospects to boost mental health budgets for socioeconomic
1st revised: June 23, 2024
development. Governments should conduct consistent mental health investment
2nd revised:June 28, 2024 cases and expedite fiscal space for aggressive taxation to health reforms.
3rd revised:July 23, 2024
4th revised:August 3, 2024 Keywords: Financing; Mental healthcare; Fiscal space; Universal health coverage; Health
Accepted: August 15, 2024 insurance, Uganda
Published online: October 18,
2024
Copyright: © 2024 Author(s). 1. Introduction
This is an Open-Access article
distributed under the terms of the Fiscal space for mental health continues to be a driver for socioeconomic growth. In
Creative Commons Attribution sub-Saharan Africa (SSA), mental health has eroded significantly during the past
License, permitting distribution,
and reproduction in any medium, several decades. In 2019, close to one billion people suffered from mental disorders,
provided the original work is 82% of whom were estimated to be in low- and middle-income countries (LMICs). In
properly cited. contrast, nearly one in four people globally suffered from a mental disorder by 2022
Publisher’s Note: AccScience (Kestel, 2022). In SSA, poor funding reduces access to care, leading to high treatment
Publishing remains neutral with gaps and out-of-pocket expenditures. Pervasive income inequality, lack of employment,
regard to jurisdictional claims in
published maps and institutional and growing poverty are other main drivers for the soaring mental disorders, which
affiliations. are compounded by ongoing political and social distress. The determinants of

Volume 3 Issue 2 (2025) 21 https://doi.org/10.36922/ghes.3700