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Table 2 Opportunities and threats within the Nigerian Context

From: Sustainable financing mechanisms for strengthening mental health systems in Nigeria

Opportunities Threats
Health system factors Health system factors
A new mental health bill is before the National Assembly
Implementation of task-shifting and integration of mental health into primary care with training of primary health care providers on mental health using the mental health gap action programme intervention guide (mhGAP-IG) is increasingly becoming acceptable across the country
The adoption of the mhGAP Implementation Plan by the National Council of Health in 2013 for the scaling up of mental health service in the country
Implementation of health insurance schemes; and pilot studies of VCHIS have demonstrated promising results, which can improve access to MH services
Projects funded by EU and other donor agencies are providing new evidence and models for scaling up mental health care services in Nigeria
Health insurance for the informal sector workers is yet to begin
Spill-over effects of internal crises (insurgency) on the health sector with resultant displacement of larger populations
Economic factors Economic factors
High projected economic growth
Tax revenue expected to improve
Massive investment in the power sector to boost generation capacity and productivity
Fall in international oil price
Budget deficit and negative current account balance
High levels of poverty, unemployment, adult illiteracy, and population growth
Economic Recession in Nigeria from second quarter of 2016
Political factors Political factors
Encouraging policy environment for health
New UN resolution on NCDs, including the SDGs which include specific targets for mental health
New health sector policies/plans focus on strengthening primary care and sustainable health financing
Determination to fight corruption by the government
Insurgency and political tension and power struggles
Low scores on polity, stability, and corruption indexes; instability of neighbouring countries
Neglect of Mental Health in the 2014 National Health Act and the delay in passing the National Mental Health Bill by the National Assembly