IDEAS home Printed from https://ideas.repec.org/a/bla/ijhplm/v37y2022i1p271-280.html
   My bibliography  Save this article

Efficiency of district hospitals in Zimbabwe: Assessment, drivers and policy implications

Author

Listed:
  • Marlène Guillon
  • Martine Audibert
  • Jacky Mathonnat

Abstract

The Government of Zimbabwe is committed to making progress towards universal health coverage. Unmet health needs are huge and the health system suffers from serious dysfunctions and weaknesses. The situation is further complicated by a weak governance. To address these challenging issues, many of which would require an increase in public health expenditures, the government faces severe macroeconomic constraints. In this context, improving the efficiency of public health expenditures is of paramount importance. This study focuses on the efficiency of district hospitals, whose role is crucial for the strengthening of the health care system and achieving significant results in implementing the universal health coverage. Based on a sample of 31 district hospitals observed from 2015 to 2017 we use the double bootstrap procedure developed by Simar and Wilson to (a) estimate bias‐adjusted DEA efficiency scores and to (b) investigate the factors associated with the previously calculated scores using truncated regression. The average efficiency of district hospitals is low and stagnant over 2015–2017. The findings suggest the existence of a significant room for maneuver to get more results with the resources spent. The analysis of the efficiency drivers shows the importance of both supply and demand‐side factors, leading to several policy‐oriented considerations. The study also highlights important shortcomings in the routine collection of basic data that need to be addressed by the Ministry of Health and Child Care.

Suggested Citation

  • Marlène Guillon & Martine Audibert & Jacky Mathonnat, 2022. "Efficiency of district hospitals in Zimbabwe: Assessment, drivers and policy implications," International Journal of Health Planning and Management, Wiley Blackwell, vol. 37(1), pages 271-280, January.
  • Handle: RePEc:bla:ijhplm:v:37:y:2022:i:1:p:271-280
    DOI: 10.1002/hpm.3337
    as

    Download full text from publisher

    File URL: https://doi.org/10.1002/hpm.3337
    Download Restriction: no

    File URL: https://libkey.io/10.1002/hpm.3337?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Oleg Badunenko & Pavlo Mozharovskyi, 2016. "Nonparametric frontier analysis using Stata," Stata Journal, StataCorp LP, vol. 16(3), pages 550-589, September.
    2. Bruce Hollingsworth, 2008. "The measurement of efficiency and productivity of health care delivery," Health Economics, John Wiley & Sons, Ltd., vol. 17(10), pages 1107-1128, October.
    3. Murad Ali & Megersa Debela & Tewfik Bamud, 2017. "Technical efficiency of selected hospitals in Eastern Ethiopia," Health Economics Review, Springer, vol. 7(1), pages 1-13, December.
    4. Audibert, Martine & Mathonnat, Jacky & Pelissier, Aurore & Huang, Xiao Xian & Ma, Anning, 2013. "Health insurance reform and efficiency of township hospitals in rural China: An analysis from survey data," China Economic Review, Elsevier, vol. 27(C), pages 326-338.
    5. Helene Barroy & Susan Sparkes & Elina Dale & Jacky Mathonnat, 2018. "Can Low- and Middle-Income Countries Increase Domestic Fiscal Space for Health: A Mixed-Methods Approach to Assess Possible Sources of Expansion," Post-Print hal-02137487, HAL.
    6. Jacobs,Rowena & Smith,Peter C. & Street,Andrew, 2006. "Measuring Efficiency in Health Care," Cambridge Books, Cambridge University Press, number 9780521851442, October.
    7. Martine Audibert & Jacky Mathonnat & Aurore Pelissier & Xiao Xian Huang & Anning Ma, 2013. "Health insurance reform and efficiency of township hospitals in rural China: An analysis from survey data," Post-Print halshs-01230210, HAL.
    8. Varabyova, Yauheniya & Schreyögg, Jonas, 2013. "International comparisons of the technical efficiency of the hospital sector: Panel data analysis of OECD countries using parametric and non-parametric approaches," Health Policy, Elsevier, vol. 112(1), pages 70-79.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Jacky Mathonnat, 2024. "« Transforming Challenge into Action: Expanding Health Coverage for All » at the World Bank Group and IMF Spring Meetings 2024," Post-Print hal-04603235, HAL.
    2. Gökçe Manavgat & Martine Audibert, 2024. "Healthcare system efficiency and drivers: Re-evaluation of OECD countries for COVID-19," Post-Print hal-04350906, HAL.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Kejia Chu & Ning Zhang & Zhongfei Chen, 2015. "The Efficiency and Its Determinants for China’s Medical Care System: Some Policy Implications for Northeast Asia," Sustainability, MDPI, vol. 7(10), pages 1-20, October.
    2. Alonso, José M. & Clifton, Judith & Díaz-Fuentes, Daniel, 2015. "The impact of New Public Management on efficiency: An analysis of Madrid's hospitals," Health Policy, Elsevier, vol. 119(3), pages 333-340.
    3. Berger, Michael & Sommersguter-Reichmann, Margit & Czypionka, Thomas, 2020. "Determinants of soft budget constraints: how public debt affects hospital performance in Austria," LSE Research Online Documents on Economics 116865, London School of Economics and Political Science, LSE Library.
    4. See, Kok Fong & Ng, Ying Chu, 2021. "Do hospital reform and ownership matter to Shenzhen hospitals in China? A productivity analysis," Economic Analysis and Policy, Elsevier, vol. 72(C), pages 145-155.
    5. Iablonskii, K. & Fedotov, Y., 2015. "Organizational performance measurement of healthcare organizations," Working Papers 6422, Graduate School of Management, St. Petersburg State University.
    6. Martine AUDIBERT & Marlène GUILLON & Jacky MATHONNAT, 2018. "The challenge of improving efficiency of Soum Health Centers in Mongolia," Working Papers P226, FERDI.
    7. Laurène PETITFOUR & Xiezhe HUANGFU & Martine AUDIBERT & Jacky MATHONNAT, 2017. "Efficiency of township hospitals in China in the context of the drug policy reform: Progress should not get bogged in midstream - A case study from a survey in Weifang prefecture," Working Papers P185, FERDI.
    8. Martine AUDIBERT & Marlène GUILLON & Jacky MATHONNAT, 2018. "The challenge of improving efficiency of Soum Health Centers in Mongolia," Working Papers P226, FERDI.
    9. Puertas, Rosa & Marti, Luisa & Guaita-Martinez, José M., 2020. "Innovation, lifestyle, policy and socioeconomic factors: An analysis of European quality of life," Technological Forecasting and Social Change, Elsevier, vol. 160(C).
    10. Sebastian Kohl & Jan Schoenfelder & Andreas Fügener & Jens O. Brunner, 2019. "The use of Data Envelopment Analysis (DEA) in healthcare with a focus on hospitals," Health Care Management Science, Springer, vol. 22(2), pages 245-286, June.
    11. Anthun, Kjartan Sarheim & Kittelsen, Sverre Andreas Campbell & Magnussen, Jon, 2017. "Productivity growth, case mix and optimal size of hospitals. A 16-year study of the Norwegian hospital sector," Health Policy, Elsevier, vol. 121(4), pages 418-425.
    12. Akkan, Can & Karadayi, Melis Almula & Ekinci, Yeliz & Ülengin, Füsun & Uray, Nimet & Karaosmanoğlu, Elif, 2020. "Efficiency analysis of emergency departments in metropolitan areas," Socio-Economic Planning Sciences, Elsevier, vol. 69(C).
    13. Martine Audibert & Marlène Guillon & Jacky Mathonnat, 2018. "The challenge of improving efficiency of Soum Health Centers in Mongolia - What data tell us for Soum Health Centers in five provinces?," Working Papers hal-01795645, HAL.
    14. Martine Audibert & Marlène Guillon & Jacky Mathonnat, 2018. "The challenge of improving efficiency of Soum Health Centers in Mongolia - What data tell us for Soum Health Centers in five provinces?," Post-Print hal-01795645, HAL.
    15. Laurène PETITFOUR & Xiezhe HUANGFU & Martine AUDIBERT & Jacky MATHONNAT, 2017. "Efficiency of township hospitals in China in the context of the drug policy reform: Progress should not get bogged in midstream - A case study from a survey in Weifang prefecture," Working Papers P185, FERDI.
    16. Varabyova, Yauheniya & Müller, Julia-Maria, 2016. "The efficiency of health care production in OECD countries: A systematic review and meta-analysis of cross-country comparisons," Health Policy, Elsevier, vol. 120(3), pages 252-263.
    17. Bo Li & Muhammad Mohiuddin & Qian Liu, 2019. "Determinants and Differences of Township Hospital Efficiency among Chinese Provinces," IJERPH, MDPI, vol. 16(9), pages 1-16, May.
    18. José M. Cordero & Agustín García-García & Enrique Lau-Cortés & Cristina Polo, 2021. "Efficiency and Productivity Change of Public Hospitals in Panama: Do Management Schemes Matter?," IJERPH, MDPI, vol. 18(16), pages 1-21, August.
    19. Ferreira, D.C. & Marques, R.C., 2019. "Do quality and access to hospital services impact on their technical efficiency?," Omega, Elsevier, vol. 86(C), pages 218-236.
    20. Laudicella, Mauro & Olsen, Kim Rose & Street, Andrew, 2010. "Examining cost variation across hospital departments-a two-stage multi-level approach using patient-level data," Social Science & Medicine, Elsevier, vol. 71(10), pages 1872-1881, November.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:bla:ijhplm:v:37:y:2022:i:1:p:271-280. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Wiley Content Delivery (email available below). General contact details of provider: http://www.blackwellpublishing.com/journal.asp?ref=0749-6753 .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.