Technical and scale efficiency in the delivery of child health services in Zambia: results from data envelopment analysis

Tom Achoki, Anke Hovels, Felix Masiye, Abaleng Lesego, Hubert Leufkens, Yohannes KINFU

Research output: Contribution to journalArticle

2 Citations (Scopus)
7 Downloads (Pure)

Abstract

Objective: Despite tremendous efforts to scale up key maternal and child health interventions in Zambia, progress has not been uniform across the country. This raises fundamental health system performance questions that require further investigation. Our study investigates technical and scale efficiency (SE) in the delivery of maternal and child health services in the country. Setting: The study focused on all 72 health districts of Zambia. Methods: We compiled a district-level database comprising health outcomes (measured by the probability of survival to 5 years of age), health outputs (measured by coverage of key health interventions) and a set of health system inputs, namely, financial resources and human resources for health, for the year 2010. We used data envelopment analysis to assess the performance of subnational units across Zambia with respect to technical and SE, controlling for environmental factors that are beyond the control of health system decision makers. Results: Nationally, average technical efficiency with respect to improving child survival was 61.5% (95% CI 58.2% to 64.8%), which suggests that there is a huge inefficiency in resource use in the country and the potential to expand services without injecting additional resources into the system. Districts that were more urbanised and had a higher proportion of educated women were more technically efficient. Improved cooking methods and donor funding had no significant effect on efficiency. Conclusions: With the pressing need to accelerate progress in population health, decision makers must seek efficient ways to deliver services to achieve universal health coverage. Understanding the factors that drive performance and seeking ways to enhance efficiency offer a practical pathway through which low-income countries could improve population health without necessarily seeking additional resources.

Original languageEnglish
Article numbere012321
Pages (from-to)1-12
Number of pages12
JournalBMJ Open
Volume7
Issue number1
DOIs
Publication statusPublished - 1 Jan 2017

Fingerprint Dive into the research topics of 'Technical and scale efficiency in the delivery of child health services in Zambia: results from data envelopment analysis'. Together they form a unique fingerprint.

Cite this