Assessment of technical and scale efficiency of public clinics in eSwatini

dc.contributor.advisorAtaguba, John
dc.contributor.authorKindandi, Kikanda
dc.date.accessioned2021-02-01T07:35:10Z
dc.date.available2021-02-01T07:35:10Z
dc.date.issued2020
dc.date.updated2021-01-31T05:43:20Z
dc.description.abstractDeveloping countries, while working to achieve the WHO universal health coverage goal, have to constantly strike a balance, when allocating their already limited resources, between health and other sectors of their economies (agriculture, education, infrastructure, housing, security, defence etc..). As a result, there is always a limit on how much funding developing countries local governments are able to allocate to their health sector. Limited heath sector funding in the presence of significant health care needs may in turn have a negative impact on health systems outcomes. In addition to government health financing constraints, health systems outcomes in developing countries may also be jeopardized by the prevalence of inefficiencies within local health care delivery systems, especially within public health facilities. This study investigates the level of technical and scale efficiency of a nationally representative sample of 65 randomly selected public clinics in Eswatini using Data Envelopment Analysis. The DEA estimates indicate that 42 clinics (64.7%) were technically inefficient, with an average technical efficiency score of 80.4% (STD= 18.8%). Fifty-one (78.4%) clinics were scale inefficient with an average scale efficiency score of 90.4% (STD = 6.6%). The most prevalent scale inefficiency among public clinics was increasing return to scale with 92.2% (47/51) of scale inefficient clinics operating under increasing return to scale. All 42 inefficient clinics could have delivered the same level of output with 5,701,449.4, US $ less in government funding, 115.3 less clinical staff, 138.8 less support staff and 119.8 less consultation rooms The results reveal inefficiencies within the Health system in Eswatini. It seems possible to save significant amount of money if measures were put in place to mitigate resource wastages. Hence, policy interventions that help not only optimize inputs but also allow outputs expansion through improving the demand for health care would contribute to improving technical and scale efficiency of public clinics in the Kingdom of Eswatini.
dc.identifier.apacitationKindandi, K. (2020). <i>Assessment of technical and scale efficiency of public clinics in eSwatini</i>. (). ,Faculty of Health Sciences ,Department of Public Health and Family Medicine. Retrieved from http://hdl.handle.net/11427/32738en_ZA
dc.identifier.chicagocitationKindandi, Kikanda. <i>"Assessment of technical and scale efficiency of public clinics in eSwatini."</i> ., ,Faculty of Health Sciences ,Department of Public Health and Family Medicine, 2020. http://hdl.handle.net/11427/32738en_ZA
dc.identifier.citationKindandi, K. 2020. Assessment of technical and scale efficiency of public clinics in eSwatini. . ,Faculty of Health Sciences ,Department of Public Health and Family Medicine. http://hdl.handle.net/11427/32738en_ZA
dc.identifier.ris TY - Master Thesis AU - Kindandi, Kikanda AB - Developing countries, while working to achieve the WHO universal health coverage goal, have to constantly strike a balance, when allocating their already limited resources, between health and other sectors of their economies (agriculture, education, infrastructure, housing, security, defence etc..). As a result, there is always a limit on how much funding developing countries local governments are able to allocate to their health sector. Limited heath sector funding in the presence of significant health care needs may in turn have a negative impact on health systems outcomes. In addition to government health financing constraints, health systems outcomes in developing countries may also be jeopardized by the prevalence of inefficiencies within local health care delivery systems, especially within public health facilities. This study investigates the level of technical and scale efficiency of a nationally representative sample of 65 randomly selected public clinics in Eswatini using Data Envelopment Analysis. The DEA estimates indicate that 42 clinics (64.7%) were technically inefficient, with an average technical efficiency score of 80.4% (STD= 18.8%). Fifty-one (78.4%) clinics were scale inefficient with an average scale efficiency score of 90.4% (STD = 6.6%). The most prevalent scale inefficiency among public clinics was increasing return to scale with 92.2% (47/51) of scale inefficient clinics operating under increasing return to scale. All 42 inefficient clinics could have delivered the same level of output with 5,701,449.4, US $ less in government funding, 115.3 less clinical staff, 138.8 less support staff and 119.8 less consultation rooms The results reveal inefficiencies within the Health system in Eswatini. It seems possible to save significant amount of money if measures were put in place to mitigate resource wastages. Hence, policy interventions that help not only optimize inputs but also allow outputs expansion through improving the demand for health care would contribute to improving technical and scale efficiency of public clinics in the Kingdom of Eswatini. DA - 2020_ DB - OpenUCT DP - University of Cape Town KW - Health Economics LK - https://open.uct.ac.za PY - 2020 T1 - Assessment of technical and scale efficiency of public clinics in eSwatini TI - Assessment of technical and scale efficiency of public clinics in eSwatini UR - http://hdl.handle.net/11427/32738 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/32738
dc.identifier.vancouvercitationKindandi K. Assessment of technical and scale efficiency of public clinics in eSwatini. []. ,Faculty of Health Sciences ,Department of Public Health and Family Medicine, 2020 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/32738en_ZA
dc.language.rfc3066eng
dc.publisher.departmentDepartment of Public Health and Family Medicine
dc.publisher.facultyFaculty of Health Sciences
dc.subjectHealth Economics
dc.titleAssessment of technical and scale efficiency of public clinics in eSwatini
dc.typeMaster Thesis
dc.type.qualificationlevelMasters
dc.type.qualificationlevelMPH
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