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Assessing efficiency maternal and child health services in Morocco: data envelopement analysis and Tobit model

Author

Listed:
  • Youssef Er-Rays

    (Ibn Tofail University, Research Laboratory in Organizational Management Sciences)

  • Meriem M’dioud

    (Ibn Tofail University, National School of Applied Sciences)

  • Hamid Ait-Lemqeddem

    (Ibn Tofail University, Research Laboratory in Organizational Management Sciences)

  • Mustapha Ezzahiri

    (Doukkali University)

Abstract

Efficiency analysis of the Maternal, Newborn, and Child Services Network (MNCSN) is crucial for achieving SDG 2030. However, the mortality rates of maternal, newborn, and child have not reduced since 2018, and there have been limited studies conducted in Morocco on this subject. This study aims to analyze the technical efficiency of 82 MNCSN across primary healthcare Establishments Network (PHCEN) in Morocco in 2021 and identify factors influencing their efficiency. Technical efficiency was estimated using the Data Envelopment Analysis (DEA) method with an input orientation. Tobit regression was employed to analyze factors affecting the technical efficiency of maternal and child healthcare. In the initial stage, the average efficiency score of the 82 MNCSN was 0.779 for constant returns, with 36 MNCSN achieving a score of 1. However, the Boujdour MNCSN recorded the lowest efficiency score of 0.033. In the second stage, Tobit regression revealed that Model 2 was more significant than Model 1. Specifically, the explanatory variable Rural Dispensary exhibited strong statistical significance and a positive impact on maternal and child health, followed by variables such as High-risk Pregnancies Supported and High-risk Pregnancies. The study findings suggest that the resources allocated for MNCSN in Morocco are not being efficiently utilized compared to some other African and European countries. Therefore, the Ministry of Health in Morocco should review the functions of MNCSN, aiming to improve the delivery of maternal, newborn, and child healthcare, regardless of the setting, be it urban or rural.

Suggested Citation

  • Youssef Er-Rays & Meriem M’dioud & Hamid Ait-Lemqeddem & Mustapha Ezzahiri, 2024. "Assessing efficiency maternal and child health services in Morocco: data envelopement analysis and Tobit model," Quality & Quantity: International Journal of Methodology, Springer, vol. 58(6), pages 5577-5619, December.
    • Handle: RePEc:spr:qualqt:v:58:y:2024:i:6:d:10.1007_s11135-024-01893-y
    DOI: 10.1007/s11135-024-01893-y
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    1. Nikolaos Oikonomou & Yannis Tountas & Argiris Mariolis & Kyriakos Souliotis & Kostas Athanasakis & John Kyriopoulos, 2016. "Measuring the efficiency of the Greek rural primary health care using a restricted DEA model; the case of southern and western Greece," Health Care Management Science, Springer, vol. 19(4), pages 313-325, December.
    2. Coelli, Tim J., 1995. "Recent Developments In Frontier Modelling And Efficiency Measurement," Australian Journal of Agricultural Economics, Australian Agricultural and Resource Economics Society, vol. 39(3), pages 1-27, December.
    3. Amemiya, Takeshi, 1973. "Regression Analysis when the Dependent Variable is Truncated Normal," Econometrica, Econometric Society, vol. 41(6), pages 997-1016, November.
    4. Knox Lovell, C. A. & Pastor, Jesus T. & Turner, Judi A., 1995. "Measuring macroeconomic performance in the OECD: A comparison of European and non-European countries," European Journal of Operational Research, Elsevier, vol. 87(3), pages 507-518, December.
    5. Una Okonkwo Osili & Jia Xie, 2009. "Do Immigrants and Their Children Free Ride More Than Natives?," American Economic Review, American Economic Association, vol. 99(2), pages 28-34, May.
    6. 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.
    7. Adler, Nicole & Yazhemsky, Ekaterina, 2010. "Improving discrimination in data envelopment analysis: PCA-DEA or variable reduction," European Journal of Operational Research, Elsevier, vol. 202(1), pages 273-284, April.
    8. William W. Cooper & Lawrence M. Seiford & Kaoru Tone, 2007. "Returns to Scale," Springer Books, in: Data Envelopment Analysis, edition 0, chapter 5, pages 131-176, Springer.
    9. Charnes, A. & Cooper, W. W. & Rhodes, E., 1978. "Measuring the efficiency of decision making units," European Journal of Operational Research, Elsevier, vol. 2(6), pages 429-444, November.
    10. Enzo Barberio Mariano & Diogo Ferraz & Simone Cristina Oliveira Gobbo, 2021. "The Human Development Index with Multiple Data Envelopment Analysis Approaches: A Comparative Evaluation Using Social Network Analysis," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 157(2), pages 443-500, September.
    11. Diogo Ferraz & Enzo B. Mariano & Daisy Rebelatto & Dominik Hartmann, 2020. "Linking Human Development and the Financial Responsibility of Regions: Combined Index Proposals Using Methods from Data Envelopment Analysis," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 150(2), pages 439-478, July.
    12. Rahab Mbau & Anita Musiega & Lizah Nyawira & Benjamin Tsofa & Andrew Mulwa & Sassy Molyneux & Isabel Maina & Julie Jemutai & Charles Normand & Kara Hanson & Edwine Barasa, 2023. "Analysing the Efficiency of Health Systems: A Systematic Review of the Literature," Applied Health Economics and Health Policy, Springer, vol. 21(2), pages 205-224, March.
    13. McDonald, John, 2009. "Using least squares and tobit in second stage DEA efficiency analyses," European Journal of Operational Research, Elsevier, vol. 197(2), pages 792-798, September.
    14. Kostas Kounetas & Fotis Papathanassopoulos, 2013. "How efficient are Greek hospitals? A case study using a double bootstrap DEA approach," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 14(6), pages 979-994, December.
    15. Hoff, Ayoe, 2007. "Second stage DEA: Comparison of approaches for modelling the DEA score," European Journal of Operational Research, Elsevier, vol. 181(1), pages 425-435, August.
    16. OGLOBLIN, Constantin, 2011. "Health Care Efficiency Across Countries: A Stochastic Frontier Analysis," Applied Econometrics and International Development, Euro-American Association of Economic Development, vol. 11(1).
    17. Amemiya, Takeshi, 1984. "Tobit models: A survey," Journal of Econometrics, Elsevier, vol. 24(1-2), pages 3-61.
    18. Paul Marschall & Steffen Flessa, 2011. "Efficiency of primary care in rural Burkina Faso. A two-stage DEA analysis," Health Economics Review, Springer, vol. 1(1), pages 1-15, December.
    19. Youssef Er-Rays & Meriem M'dioud, 2024. "Evaluating the Financial Factors Influencing Maternal, Newborn, and Child Health in Africa," Papers 2402.14939, arXiv.org.
    20. Day, Diana L. & Lewin, Arie Y. & Li, Hongyu, 1995. "Strategic leaders or strategic groups: A longitudinal data envelopment analysis of the U.S. brewing industry," European Journal of Operational Research, Elsevier, vol. 80(3), pages 619-638, February.
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