Health system productivity change in Zambia: A focus on the child health services

Tom Achoki, Yohannes KINFU, Felix Masiye, Geert Frederix, Anke Hovels, Hubert Leufkens

    Research output: Contribution to journalArticlepeer-review

    2 Citations (Scopus)


    Efficiency and productivity improvement have become central in global health debates. In this study, we explored productivity change, particularly the contribution of technological progress and efficiency gains associated with improvements in child survival in Zambia (population 15 million). Productivity was measured by applying the Malmquist productivity index on district-level panel data. The effect of socioeconomic factors was further analyzed by applying an ordinary least squares regression technique. During 2004–2009, overall productivity in Zambia increased by 5.0 per cent, a change largely attributed to technological progress rather than efficiency gains. Within-country productivity comparisons revealed wide heterogeneity in favor of more urbanized and densely populated districts. Improved cooking methods, improved sanitation, and better educated populations tended to improve productive gains, whereas larger household size had an adverse effect. Addressing such district-level factors and ensuring efficient delivery and optimal application of existing health technologies offer a practical pathway for further improving population health
    Original languageEnglish
    Pages (from-to)88-104
    Number of pages17
    JournalJournal of Public Health Policy
    Issue number1
    Publication statusPublished - 1 Feb 2017


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