Estimating the Efficiency of Healthcare Facilities Providing HIV/AIDS Treatment in Zambia: A Data Envelopment Approach
Zambia and many other countries in Sub-Saharan Africa face a key challenge of sustaining high levels of coverage of AIDS treatment under prospects of dwindling global resources for HIV/AIDS treatment. Policy debate in HIV/AIDS is increasingly paying more focus to efficiency in the use of available resources. In this chapter, we apply Data Envelopment Analysis (DEA) to estimate short term technical efficiency of 34 HIV/AIDS treatment facilities in Zambia. The data consists of input variables such as human resources, medical equipment, building space, drugs, medical supplies, and other materials used in providing HIV/AIDS treatment. Two main outputs namely, numbers of ART-years (Anti-Retroviral Therapy-years) and pre-ART-years are included in the model. Results show the mean technical efficiency score to be 83 %, with great variability in efficiency scores across the facilities. Scale inefficiency is also shown to be significant. About half of the facilities were on the efficiency frontier. We also construct bootstrap confidence intervals around the efficiency scores.
KeywordsData Envelopment Analysis HIV/AIDS treatment Healthcare efficiency Zambia Managing Service Productivity
We are grateful to the Clinton Health Access Initiative Zambia Country Office for supporting the data collection and making the data available for this analysis. We thank Mr Bona Chitah of the University of Zambia, Department of Economics, for assistance in explaining the data collection process. The views expressed in this chapter do not necessarily represent those of the funder. Any errors are our own.
- Fare, R., Grosskopf, S., & Lovell, C. A. K. (1994). Production frontiers. Cambridge: Cambridge University Press.Google Scholar
- Ichoku, H., Fonta, W. M., Onwujekwe, O. E., & Kirigia, J. M. (2011). Evaluating the technical efficiency of hospitals in South Eastern Nigeria. European Journal of Business and Management, 3(2), 24–37.Google Scholar
- Kirigia, J. M., Lambo, E., & Sambo, L. G. (2000). Are public hospitals in Kwazulu-Natal province of South Africa technically efficient? African Journal of Health Sciences, 7(3–4), 25–32.Google Scholar
- Over, M. (2011). Achieving an AIDS transition: Preventing infections to sustain treatment. Washington, DC: Center for Global Development.Google Scholar
- Wilson, P. W. (2006). FEAR: A software package for frontier efficiency analysis with R. Accessed February 2013, from http://www.clemson.edu/faculty/Wilson