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Global collective action in mental health financing: Allocation of development assistance for mental health in 142 countries, 2000–2015
Social Science & Medicine ( IF 5.4 ) Pub Date : 2021-08-30 , DOI: 10.1016/j.socscimed.2021.114354
Valentina Iemmi 1
Affiliation  

Collective action between international donors is central to the mobilisation of global solidarity in global health. This is especially important in mental health where resources remain extremely limited. In this paper I investigate global collective action in mental health financing, looking at the responsiveness of international donors to mental health needs in low- and middle-income countries (LMICs). I analyse factors at the level of recipient countries (needs, interests, policy environment) associated with allocation of development assistance for mental health (DAMH) using a two-part regression model applied to a time series cross-sectional dataset of 142 LMICs between 2000 and 2015. Findings reveal that international donors’ disbursements are not well aligned with mental health needs of recipient countries, and, moreover, contextual factors might be playing more prominent roles in resource allocation. Countries are more likely to receive DAMH if they experience significant outbreaks of infectious diseases or have lower gross domestic product (GDP) per capita and lower market openness. Selected recipient countries are more likely to receive higher DAMH amounts per capita if they have lower GDP per capita, higher government health expenditure, or higher mortality rates due to conflicts or natural disasters. Past DAMH recipients are more likely to be selected and, when selected, to receive higher DAMH amounts per capita. My results demonstrate that more holistic collective action amongst international donors is required to address mental health needs in LMICs. Investments should better reflect needs, particularly during and after emergencies such as COVID-19, and could be amplified by leveraging synergies across other health conditions and sectors.



中文翻译:

精神卫生筹资方面的全球集体行动:2000-2015 年 142 个国家精神卫生发展援助的分配

国际捐助者之间的集体行动对于在全球卫生领域动员全球团结至关重要。这在资源仍然极其有限的心理健康中尤为重要。在本文中,我调查了精神卫生筹资方面的全球集体行动,着眼于国际捐助者对中低收入国家 (LMIC) 精神卫生需求的反应。我将两部分回归模型应用于 2000 年之间 142 个中低收入国家的时间序列横截面数据集,分析了受援国层面(需求、利益、政策环境)与精神卫生发展援助(DAMH)分配相关的因素和 2015 年。调查结果显示,国际捐助者的支出与受援国的心理健康需求并不一致,此外,背景因素可能在资源分配中发挥更突出的作用。如果国家经历重大传染病暴发或人均国内生产总值 (GDP) 较低且市场开放度较低,则这些国家更有可能获得 DAMH。如果特定的受援国人均 GDP 较低、政府卫生支出较高或由于冲突或自然灾害导致死亡率较高,则这些国家更有可能获得较高的人均 DAMH 金额。过去的 DAMH 接受者更有可能被选中,并且在被选中后,人均获得更高的 DAMH 金额。我的研究结果表明,需要国际捐助者采取更全面的集体行动来解决中低收入国家的心理健康需求。投资应更好地反映需求,尤其是在 COVID-19 等紧急情况期间和之后,

更新日期:2021-09-04
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