Skip to main content

Advertisement

SpringerLink
Log in

Efficient Management of Health Centres Human Resources in Zambia

  • Original Paper
  • Published:
Journal of Medical Systems Aims and scope Submit manuscript

Abstract

This study uses Data Envelopment Analysis (DEA) to estimate the degree of technical, allocative and cost efficiency in individual public and private health centres in Zambia; and to identify the relative inefficiencies in the use of various inputs among individual health centers. About 83% of the 40 health centres were technically inefficient; and 88% of them were both allocatively and cost inefficient. The privately owned health centers were found to be more efficient than public facilities.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. WHO, The World Health Report 2000: Improving Health Systems Peformance, WHO, Geneva, 2000a.

  2. WHO, The Bulletin of the World Health Organization, WHO, Geneva, 2000b.

    Google Scholar 

  3. Murray, C. J. L., and Frenk, J., A framework for assessing the performance of health systems. Bull. WHO. 78(6):717–731, 2000.

    Google Scholar 

  4. Williams, A., Science or Marketing at WHO? A commentary on ‘World Health 2000’. Health Econ. 10(93):93–100, 2000.

    Google Scholar 

  5. Wagstaff, A., Measuring equity in health care financing: reflections on and alternatives to the World Health Organizations fairness of financing index. Development Research Group and Human Development Network, World Bank, 2001.

  6. Shaw, R. P., World Health Report 2000 “Financial Fairness Indicator”. Useful compass or crystal ball? Int. J. Health Serv. 32(1):195–203, 2002.

    Article  Google Scholar 

  7. Pedersen, K. M., The World Health Report 2000: dialogue of the deaf. Health Econ. 11:93–101, 2002.

    Article  Google Scholar 

  8. UNDP, The Human Development Report 2002, Oxford University Press, Oxford, 2002.

    Google Scholar 

  9. Masiye, F., Ndulo, M., Roos, P., and Odegaard, K., A comparative analysis of hospitals in Zambia: a pilot study on efficiency measurement and monitoring. In: Seshamani, V., Mwikisa, C. N., and Odegaard, K. (eds.), Zambias Health Reforms Selected Papers 1995–2000 Chapter 7, Sweden, Lund, pp. 95–107, 2002.

  10. WHO, World Health Report 2001, WHO, Geneva, 2001a.

    Google Scholar 

  11. UNDP, The Human Development Report 2001, Oxford University, Oxford, 2001.

    Google Scholar 

  12. United Nations, The millenium international development goals, United Nations, New York, 2000.

    Google Scholar 

  13. WHO, Regional Office for Africa, Health-for-all policy for the 21st century in the African Region: agenda 2020, WHO, Harare, 2000.

    Google Scholar 

  14. WHO, Macroeconomics and Health: Investing in Health for Economic Development, World Health Organization, Geneva, 2001b.

    Google Scholar 

  15. New Partnership for Africas Development, Human Development Programme: Health. Republic of South Africa, Pretoria, 2000.

  16. Mooney, G. H., Economics, medicine and health care, Harvester Wheatsheaf, New York, 1986.

    Google Scholar 

  17. Culyer, A. J., The morality of efficiency in health care: some uncomfortable implications. Health Econ. 1(1):7–18, 1992.

    Google Scholar 

  18. Saltman, R. B., and Ferrousier-Davis, O., The concept of stewardship in health policy. Bulletin World Health Organ. 78(6):732–739, 2001.

    Google Scholar 

  19. Chattopadhy, S., and Ray, C. S., Technical, Scale, and Size efficiency in Nursing home care: a nonparametric analysis of Connecticut homes. Health Econ. 5:363–373, 1996.

    Article  Google Scholar 

  20. Shroff, H. F. E., Gulledge, T. R., Haynes, K. E., and Oneill, M. K., Siting efficiency of long-term health care facilities. Socioecon. Plann. Sci. 32(1):25–43, 1998.

    Article  Google Scholar 

  21. Hollingsworth, B., and Parkin, D., The efficiency of the delivery of neonatal care in the UK. J. Public Health Med. 23(1):47–50, 2001.

    Article  Google Scholar 

  22. Jacobs, R., Alternative methods to examine hospital efficiency: data envelopment analysis and stochastic frontier analysis. Health Care Manag. Sci. 4:103–115, 2001.

    Article  Google Scholar 

  23. Ersoy, K., Kavuncubasi, S., Ozcan, Y. A., and Harris, I. I. J. M., Technical efficiencies of Turkish hospitals: DEA Approach. J. Med. Syst. 21(2):67–74, 1997.

    Article  Google Scholar 

  24. Linna, M., Nordblad, and Koivu, M., Technical and cost efficiency of oral health care provision in Finnish health centres. Soc. Sci. Med., 2002.

  25. Chang, H., Determinants of hospital efficiency: the case of central government-owned hospitals in Taiwan. Omega Int. J. Manag. Sci. 26(2):307–317, 1998.

    Article  Google Scholar 

  26. Wan, T. T. H., Hsu, N., Feng, R., Ma, A., Pan, S., and Chou, M., Technical efficiency of Nursing Units in a tertiary care hospital in Taiwan. J. Med. Sys. 26(1):21–27, 2002.

    Article  Google Scholar 

  27. Kirigia, J. M., Lambo, E., and Sambo, L. G., Are public hospitals in Kwazulu-Natal Province of South Africa technically efficient? African J. Health Sci. 7(3–4):25–32, 2000.

    Google Scholar 

  28. Kirigia, J. M., Sambo, L. G., and Scheel, H., Technical efficiency of public clinics in Kwazulu-Natal province of South Africa. East African Med. J. 78(3):S1–S13, 2001.

    Google Scholar 

  29. Zere, E. A., Addison, T., and McIntyre, D., Hospital efficiency in Sub-Saharan Africa: Evidence from South Africa. South African J. Econ. 2000.

  30. Kirigia, J. M., Emrouznejad, A., and Sambo, L. G., Measurement of technical efficiency of public hospitals in Kenya: using Data Envelopment Analysis. J. Med. Sys. 26(1):39–45, 2002a.

    Article  Google Scholar 

  31. Emrouznejad, A., An alternative DEA measure: A case of OCED countries. Appl. Econ. Lett. 10:779–782, 2003.

    Article  Google Scholar 

  32. Emrouznejad, A., Measurement efficiency and productivity in SAS/OR. J. Comput. Oper. Res. 32(7) 1665–1683, July 2005, 2004.

    Google Scholar 

  33. Emrouznejad, A., and Thanassoulis, E., A mathematical model for dynamic efficiency using data envelopment analysis. J. Appl. Math. Comput. 160(2):363–378, 14 January, 2005, 2004.

    Article  Google Scholar 

  34. Emrouznejad, Ali, and Victor, Podinovski, Data Envelopment Analysis and Performance management, Warwick Print, Coventry, UK, ISBN: 0 90268373 X, 2004.

  35. Coelli, T. J., A guide to DEAP Version 2.1: A Data Envelopment Analysis (Computer) Program. Working Paper No. 8/96. Centre for Efficiency and Productivity Analysis (CEPA), Department of Econometrics, University of New England, Armidale, Australia, 1996.

  36. Farrell, M. J., The measurement of productive efficiency. J. Royal Stat. Soc. Series A 120(III):253–281, 1957.

    Article  Google Scholar 

  37. Charnes, A., Cooper, W. W., and Rhodes, E., Measuring efficiency of decision making units. Eur. J. Oper. Res. 2–6:429–444, 1978.

    Article  MathSciNet  Google Scholar 

  38. Emrouznejad, A., Ali Emrouznejad's DEA HomePage, Warwick Business School, Coventry CV4 7AL, UK, 1995–2003.

    Google Scholar 

  39. Morey, R. C., Fine, D. J., and Loree, S. W., Comparing the allocative efficiencies of hospitals. OMEGA Int. J. Manag. Sci. 18(1):71–83, 1990.

    Article  Google Scholar 

  40. Ozcan, A., and Luke, R. D., A national study of the efficiency of hospitals in Urban Markets. Health Serv. Res. 27(6):719–739, 1993.

    Google Scholar 

  41. Lynch, J. R., and Ozcan, Y., Hospital closure: an efficiency analysis. Hospital Health Serv. Admin. 39(2):205–220, 1994.

    Google Scholar 

  42. Ozcan, Y., and Cotter, J. J., As assessment of efficiency of area agencies on aging in Virginia through data envelopment analysis. The Gerontologist 34(3):363–370, 1994.

    Google Scholar 

  43. Laura, H. T., Ozcan, Y. A., and Wogan, S. E., Mental health case management and technical efficiency. J. Med. Syst. 19(5):413–423, 1995.

    Article  Google Scholar 

  44. Ozcan, Y., Efficiency of hospital service production in local markets: the balance sheet of U.S. medical armament. Socioecon Plann. Sci. 29(2):139–150, 1995.

    Article  Google Scholar 

  45. White, K. R., Fache, R. N., and Ozcan, Y., Church ownership and hospital efficiency. Hospital Health Serv. Admin. 41(3):297–310, 1996.

    Google Scholar 

  46. Pai, C., Ozcan, Y. A., and Jiang, H. J., Regional variation in physician practice pattern: an examination of technical and cost efficiency for treating sinusitis. J. Med. Sys. 24(2):103–117, 2000.

    Article  Google Scholar 

  47. Harris, II J., Ozgen, H., and Ozcan, Y., Do mergers enhance the performance of hospital efficiency? J. Oper. Res. Soc. 51:801–811, 2000.

    Article  MATH  Google Scholar 

  48. Rollins, J., Lee, K., Xu, Y., and Ozcan, Y., Longitudinal study of health maintenance organization efficiency. Health Serv. Manage. Res. 14:249–262, 2001.

    Article  Google Scholar 

Download references

Acknowledgments

The author would like to express their thanks to anonymous reviewers for their carefully prepared report. All their points have been considered and the papers have been edited accordingly.

Author information

Authors and Affiliations

  1. Department of Economics, University of Zambia, Lusaka, Zambia

    Felix Masiye

  2. World Health Organization, Regional Office for Africa, Brazzaville, Congo

    Joses M. Kirigia & Luis G. Sambo

  3. Operations & Information Management, Aston Business School, Auston University, Birmingham, B4 7ET, UK

    Ali Emrouznejad

  4. Epidemiologist, JSI/MEASURE/Evalution, Arlington, VA, 22209, USA

    Abdou Mounkaila

  5. Planning and Policy Development, Ministry of Health, Lusaka, Zambia

    Davis Chimfwembe

  6. World Health Organization, Mbabane, Swaziland

    David Okello

Authors
  1. Felix Masiye
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Joses M. Kirigia
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ali Emrouznejad
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Luis G. Sambo
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Abdou Mounkaila
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Davis Chimfwembe
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. David Okello
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ali Emrouznejad.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Masiye, F., Kirigia, J.M., Emrouznejad, A. et al. Efficient Management of Health Centres Human Resources in Zambia. J Med Syst 30, 473–481 (2006). https://doi.org/10.1007/s10916-006-9032-1

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10916-006-9032-1

Keywords

Search

Navigation