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Economic burden of caregiving for persons with severe mental illness in sub-Saharan Africa: A systematic review

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  • Rebecca Addo
  • Samuel Agyei Agyemang
  • Yesim Tozan
  • Justice Nonvignon

Abstract

Background: Over the past two decades, the focus of mental health care has shifted from institutionalisation to community-based programs and short hospital stays. This change means that there is an increased role for caregivers, mostly family members, in managing persons with mental illness. Although there is evidence to support the benefits of deinstitutionalisation of mental health care, there are also indications of substantial burden experienced by caregivers; the evidence of which is limited in sub-Saharan Africa. However, knowledge of the nature and extent of this burden can inform the planning of mental health services that will not only benefit patients, but also caregivers and households. Objective: To systematically review the available evidence on the economic burden of severe mental illness on primary family caregivers in sub-Saharan Africa. Methods: A comprehensive search was conducted in Pubmed, CINAHL, Econlit and Web of Science with no date limitations up to September 2016 using keywords such as "burden", "cost of illness" and "economic burden" to identify relevant published literature. Articles were appraised using a standardised data extraction tool covering themes such as physical, psychological and socioeconomic burden. Results: Seven papers were included in the review. Caregivers were mostly family members with a mean age of 46.34, female and unemployed. Five out of seven studies (71%) estimated the full economic burden of severe mental illness on caregivers. The remainder of studies just described the caregiver burden. All seven papers reported moderate to severe caregiver burden characterised by financial constraint, productivity loss and lost employment. The caregiver’s level of income and employment status, severity of patient's condition and duration of mental illness were reported to negatively affect the economic burden experienced by caregivers. Conclusion: There is paucity of studies reporting the burden of severe mental illness on caregivers in sub-Saharan Africa. Further research is needed to present the nature and extent of this burden to inform service planning and policymaking.

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  • Rebecca Addo & Samuel Agyei Agyemang & Yesim Tozan & Justice Nonvignon, 2018. "Economic burden of caregiving for persons with severe mental illness in sub-Saharan Africa: A systematic review," PLOS ONE, Public Library of Science, vol. 13(8), pages 1-12, August.
    • Handle: RePEc:plo:pone00:0199830
    DOI: 10.1371/journal.pone.0199830
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    References listed on IDEAS

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    1. Tarricone, Rosanna, 2006. "Cost-of-illness analysis: What room in health economics?," Health Policy, Elsevier, vol. 77(1), pages 51-63, June.
    2. Bauer, Jan Michael & Sousa-Poza, Alfonso, 2015. "Impacts of Informal Caregiving on Caregiver Employment, Health, and Family," IZA Discussion Papers 8851, Institute of Labor Economics (IZA).
    3. Nagede Costa & Helene Derumeaux & Thomas Rapp & Valérie Garnault & Laura Ferlicoq & Sophie Gillette & Sandrine Andrieu & Bruno Vellas & Michel Lamure & Alain Grand & Laurent Molinier, 2012. "Methodological considerations in cost of illness studies on Alzheimer disease," Health Economics Review, Springer, vol. 2(1), pages 1-12, December.
    4. Drummond, Michael F. & Sculpher, Mark J. & Claxton, Karl & Stoddart, Greg L. & Torrance, George W., 2015. "Methods for the Economic Evaluation of Health Care Programmes," OUP Catalogue, Oxford University Press, edition 4, number 9780199665884, Decembrie.
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    1. Mirjana Mikulić & Ivan Ćavar & Darija Jurišić & Ivana Jelinčić & Dunja Degmečić, 2023. "Burden and Psychological Distress in Caregivers of Persons with Addictions," Challenges, MDPI, vol. 14(2), pages 1-10, April.

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