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Back ground: Despite spending huge sums of money on health every year, the African
region's burden of disease is persistently high. However, not much is known about the
efficiency of health care facilities in Africa as well as in Ethiopia, and instruments of
performance measurement are hardly applied in this context. The Ethiopian Health Sector
Transformation Plan (HSTP), a five year strategic document (2015/16 to 2019/20)
highlighted the importance of efficiency in the sector.
Objective: This study determined the relative efficiency of primary care facilities in Ethiopia.
Furthermore, it analyses the factors influencing the efficiency of these institutions.
Methods: Data on costs and resources used to provide services at Primary Health Care
facilities; Health Centers, Health Posts and primary hospitals were collected by PHC cost
study conducted by Resource Tracking and Management (RTM) project and Federal Ministry
of health. A Data Envelopment Analysis (DEA) is used to analyze data collected from
primary health service delivery points, health centers and primary hospitals, to identify the
relative efficiency score. A Tobit regression was employed to predict factors associated with
efficiency levels.
Result: The DEA analysis showed that 15 out of 40 (37.5%) of HC are relatively fully
efficient as compared to the rest of the HCs. On the other hand 10 out of24 (4l.5%) of the
primary hospitals were found to be relatively fully efficient than the rest of the primary
hospitals. The Tobit regression results showed that the high number of non-technical staff
significantly contributed to the inefficiency of the health facility. Other factors which were
found to significantly contribute to the inefficiency of the health facility are: type of health
facility (health centers are less efficient than primary hospitals) and the number of total
catchment population (the higher the catchment population the less efficient the facility).
Conclusion: The study showed that the average relative efficiency of primary hospitals is
80% while that of Health centers is 79%. This means that without any increase in the input,
by working on the factors influencing the efficiency, efficiency can be improved by 20% in
primary hospitals and by 21 % in Health Centers. This result is comparable to findings in
other African countries when compared using the relative efficiency scores.
....................................... Thesis available at ACIPH Library |
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