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Journal of Public Health

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01.04.2009 | Original Article

Assessing the efficiency of rural health centres in Burkina Faso: an application of Data Envelopment Analysis

verfasst von: Paul Marschall, Steffen Flessa

Erschienen in: Journal of Public Health | Ausgabe 2/2009

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Abstract

Background

Effective health care provision benefits from the support of measurement techniques. Contrary to the situation in industrialised countries efficiency analyses in the health care sector in Africa are a very recent phenomenon. Hardly any of the existing studies was conducted at the level of primary care.

Aim

The purpose of this study was twofold: (1) to evaluate the relative efficiency of health centres in rural Burkina Faso and (2) to investigate reasons for inefficient performance.

Methods

Data Envelopment Analysis (DEA) was applied. To account for the situation in that country, the output-oriented approach was used in connection with different returns to scale assumptions. To identify the spatial effect of the catchment area on efficiency the Tobit model was applied.

Results

According to constant returns to scale, 14 health centres were relatively efficient. The DEA projections suggest that the inefficient units were too big to be efficient. Tobit regression showed that the relatively efficient health centres are located close to villages in their catchment area.

Conclusions

For ethical reasons it is not appropriate to try to improve the efficiency of health centres by closing some of them. Their efficiency can be improved and lives can be saved if access to health centres is enhanced.

Baltussen R, Yé Y, Haddad S, Sauerborn RS (2002) Perceived quality of care of primary health care services in Burkina Faso. Health Policy Plan 17:42–48PubMedCrossRef

Banker RD, Charnes A, Cooper WW (1984) Some models for estimating technical and scale efficiencies in data envelopment analysis. Manage Sci 30:1078–1092CrossRef

Banker RD, Charnes A, Cooper WW, Swarts J, Thomas D (1989) An introduction to data envelopment analysis with some of its models and their uses. In: Chan JL, Patton JM (eds) Research in governmental and nonprofit accounting. JAI Press, Greenwich, pp 125–163

Barnum DT, McNeil S, Hart J (2007) Comparing the efficiency of public transportation subunits using data envelopment analysis. J Public Transp 10:1–16

Butler TW, Johnson WW (1997) Efficiency evaluation of Michigan prisons using data envelopment analysis. Crim Justice Rev 22:1–15CrossRef

Charnes A, Clark T, Cooper WW, Golany B (1985) A development study of data envelopment analysis in measuring the efficiency of maintenance units in U.S. Air Forces. Ann Oper Res 2:95–112CrossRef

Charnes A, Cooper WW, Rhodes E (1978) Measuring efficiency of decision making units. Eur J Oper Res 2:429–444CrossRef

Evans DB, Tandon A, Murray CJ, Lauer JA (2001) Comparative efficiency of national health systems: cross national econometric analysis. BMJ 323:307–310PubMedCrossRef

Farrell MJ (1957) The measurement of productive efficiency. J R Stat Soc Ser A (General) 120:254–281

Gupta S, Verhoeven M (2001) The efficiency of government expenditure experiences from Africa. J Policy Model 23:433–467CrossRef

Haddad S, Nougtara A, Fournier P (2006) Learning from health system reforms: lessons from Burkina Faso. Trop Med Int Health 11:1889–1897PubMedCrossRef

Hoff A (2007) Second stage DEA: comparison of approaches for modelling the DEA score. Eur J Oper Res 181:425–435CrossRef

Hollingsworth B, Dawson P, Maniadakis N (1999) Efficiency measurement of health care: a review of non-parametric methods and applications. Health Care Manag Sci 2:161–172PubMedCrossRef

Kirigia JM, Emrouznejad A, Sambo LG, Munguti N, Liambila W (2004) Using data envelopment analysis to measure the technical efficiency of public health centers in Kenya. J Med Syst 28:155–166PubMedCrossRef

Kirigia JM, Sambo LG, Scheel H (2001) Technical efficiency of public clinics in Kwazulu- Natal Province of South Africa. East Afr Med J 78(3 Suppl):S1–S13PubMed

Kouyaté B, Sie A, Yé M, De Allegri M, Müller O (2007) The great failure of malaria control in Africa: a district perspective from Burkina Faso. PLoS Med 4(6):e127. doi:10.1371/journal.pmed.0040127 PubMedCrossRef

Marschall P, Flessa S (2008) Expanding access to primary care without additional budgets? A case study from Burkina Faso. Eur J Health Econ. doi:10.1007/s10198–007–0095–9

Masiye F, Ndulo M, Roos P, Odegaard KA (2002) A comparative analysis of hospitals in Zambia: a pilot study on efficiency measurement and monitoring. In: Seshamani V, Mwikisa CN, Odegaard K (eds) Zambias Health Reforms Selected Papers 1995–2000. IHE, Lund, pp 473–481

Ministère de la Santé (2006) Annuaire statistique/ santé 2005. Ouagadougou

Mugisha F, Kouyate B, Dong H, Chepng’eno G, Sauerborn R (2004) The two faces of enhancing utilization of health-care services: determinants of patient initiation and retention in rural Burkina Faso. Bull World Health Organ 82:572–579PubMed

Ramanathan TV, Chandra KS, Thupeng WM (2003) A comparison of the technical efficiencies of health districts and hospitals in Botswana. Dev South Afr 20:307–320CrossRef

Ray SC (1991) Resource-use efficiency in public schools: a study of Connecticut data. Management Science 37:1620–1628CrossRef

Renner A, Kirigia JM, Zere EA (2005) Technical efficiency of peripheral health units in Pujehun district of Sierra Leone: a DEA application. BMC Health Serv Res 5:77. doi:10.1186/1472–6963–5–77 PubMedCrossRef

Sauerborn R (2005) Improving the quality of routine health services in the Nouna district through an iterative process of policy and research over the past 25 years. Ruprecht-Karls-Universität Heidelberg, Heidelberg

Traore C, Pale A (2005) Health inequalities in the rural district of Nouna, Bukrina Faso. Indepth health equality project. Indepth Working Paper Series No.3: Accra

Tavares G (2002) A bibliography of data envelopment analysis (1978–2001). Rutgers University, Rutcor Research Report, Piscataway

Würthwein R, Gbangou A, Sauerborn R, Schmidt C (2001) Measuring the local burden of disease. A study of years of life lost in sub-Saharan Africa. Int J Epidemiol 30:501–508PubMedCrossRef

Ye M, Sié A, Millogo O (2005) Manuel de procedures du Centre Médical avec Antenne Chirurgical de Nouna. Nouna

Zere E, Mybeeli T, Shangula K, Mandlhate C, Mutirua K, Tjivambi B, Kapenambili W (2006) Technical efficiency of district hospitals: evidence from Namibia using data envelopment analysis. Cost Eff Resour Alloc 4:5. doi:10.1186/1478–7547–4–5 PubMedCrossRef

Titel: Assessing the efficiency of rural health centres in Burkina Faso: an application of Data Envelopment Analysis
verfasst von: Paul Marschall
Steffen Flessa
Publikationsdatum: 01.04.2009
Verlag: Springer-Verlag
Erschienen in: Journal of Public Health / Ausgabe 2/2009
Print ISSN: 2198-1833
Elektronische ISSN: 1613-2238
DOI: https://doi.org/10.1007/s10389-008-0225-6

Springer Medizin

Abstract

Background

Aim

Methods

Results

Conclusions

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