Challenges in the Era of Globalization - iaabd

Proceedings of the 12th Annual Conference © 2011 IAABD
Measuring operational efficiency Healthcare facilties in Africa
Castro-Leal & al. (2000) mentioned that public health systems in Africa are very similar. Typically,
public facilities provide more than two-thirds of the medical care in the country. Also, private non-profit
organizations provide the remaining one third. The DEA method has been used extensively to assess the
operational efficiency of healthcare facilities in many countries in Europe, North and South America and
Asia. A thorough review of the literature reveals that the first hospitals and health centers performance
assessment studies were done in South Africa in the early 2000. And more recently similar studies were
conducted in Kenya, Ghana, Sierra Leone, Zambia, Angola, Bostwana, Namibia, Benin and Sudan. The
main objective of all the studies was to measure the technical and scale efficiency of a sample of hospitals
and health centers in these countries. Some of the studies also set out to assess changes in productivity of
these healthcare facilities over time. Table 2 below summarizes the findings of fifteen studies conducted
in Africa in the last decade. The main objective of these studies was to assess the technical and scale
efficiencies of healthcare facilities (Primary public hospitals, public health clinics). The DEA method was
used in all the studies. In addition, some of them used the Malmquist index was used to evaluate
productivity change over time. The following table summarizes the key efficiencies findings
Table 2. Operational efficiency assessment studies in Africa
Reference Key Efficiency Results
1) Kirigia, J.M. and Smabo, L.G. (2000). “Are public - 40% of the hospitals were technically
hospitals in Kwazulu-Natal Province of South Africa inefficient.
technically efficient?”. African journal of Health , 7 - 58% of the hospitals were found to be scale-
(3), 25-32
inefficient.
2) Kirigia, J.M. et al. (2001). “Technical Effciency of - 70% of health care clinics were inefficient,
public clinics in Kwazulu-Natal Province of South of which 16% had an efficiency score of 50%
Africa”. East African Medical Journal, 78 (3), 1-13 or less and 84% were scale inefficient
3) Kiriga, J.M. (2001).“Technical Efficiency and - 87% are found to be technically inefficient.
Productivity of Public Sector Hospitals in Three - The overall level of technical inefficiency of
South African Provinces”. South African Journal of
Economics, 69 (2), 336-358
4) Kirigia, J.M. et al. (2002). “Measurement of
hospitals is in the range of 35.1 to 46.8 per cent
Technical Efficiency of Hospitals in Kenya: Using - 26% of the hospitals were found to be
DEA”. Journal of Medical Systems, 26 (1), 39-45
5) Kirigia,J.M. et al. (2004). “Using DEA to Measure
technically inefficient
Technical Efficiency of Health Centers in Kenya”. - 44% of public health centers are inefficient
Journal of Medical Systems, 28 (2), 155-166
6) Osei1, D. et al. (2005).“Technical efficiency of - 47% of hospitals were technically inefficient
public district hospitals and health centers in Ghana: and 59% were scale inefficient
a pilot study”. Cost Effectiveness and Resource - 18% of the health centers were technically
Allocation , 3 (9), 1-13
inefficient and 47% were scale inefficient
7) Renner, A. et al. (2005). “Technical efficiency of -59% of the 37 health units were found to be
health units in Pujehun district of Sierra Leone: a technically inefficient,
DEA application”. BMC Health Services Research, -65% health units were found to be scale
5 (77), 1-11
inefficient,
8) Masive, F. et al. (2006). “Efficient Management - About 83% were technically inefficient; and
of Health Centers Human Resources in Zambia”. - 88% of them were both allocatively and cost
Journal of Medical Systems, 30 (6), 473-481 inefficient.
9) Zere, E. et al. (2006). “Technical efficiency of - technically inefficient: 73% (1998), 69%
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