Efficiency and productivity analysis of maternal and infant healthcare services in Sub-Saharan Africa

Int J Health Plann Manage. 2023 Nov;38(6):1816-1832. doi: 10.1002/hpm.3705. Epub 2023 Sep 6.

Abstract

The paper examines the efficiency and productivity of Sub-Saharan African (SSA) countries towards maternal and infant healthcare services between 2015 and 2019. Data envelopment analysis is utilised to evaluate efficiency, and Malmquist-Luenberger's (ML) productivity estimation is employed for productivity analysis. The results indicate inefficiency in SSA maternal and infant healthcare services. Average efficiency is pegged at 85%, and 60% of the countries evaluated had below-average efficiency. Effects of socioeconomic dynamics of countries were analysed. Preliminary estimations on the impact of Gross domestic product (GDP), education, urban population, and total population on efficiency are not significant. Although GDP and education sometimes show that they influence efficiency positively. Sensitivity analysis indicates efficiency to be more responsive to health expenditure, as well as to nurses and midwives. ML Productivity decomposition into technical efficiency change and technological change indicates improvement in technical efficiency as the principal driver of efficiency and productivity. Policy recommendations are made in line with the findings, requirements, and constraints of SSA countries.

Keywords: data envelopment analysis; efficiency; healthcare; infant mortality; malmquist-luenberger index; maternal mortality; productivity; sub-Saharan Africa.

MeSH terms

  • Africa South of the Sahara
  • Child
  • Child Health Services*
  • Educational Status
  • Family
  • Health Expenditures*
  • Humans
  • Infant