Abstract:
Abstract
Background: The efficient use of scarce resources expending on public hospitals
is especially critical in resource-limited countries for effective maternal health
service provision. Since hospitals are essential decision-making units for efficient
health services provision, they need to ensure their level of efficiency.
Objective: To assess the technical efficiency of public hospitals on maternal health
services provision and associated factors in northwest of Amhara national regional
state Ethiopia, 2020.
Methods: A facility-based cross-sectional study among randomly selected twelve
hospitals was conducted. Their inputs (salary expenditure, non-salary expenditure
and number of beds) and the maternal health services outputs (Antenatal care,
skilled deliver, and Postnatal care) data for a 2011 Ethiopian fiscal year from July
2018 to June 2019 was assessed and entered into EpiData 3.1. A Two-stage inputoriented
data
envelopment
analysis
with
variable
returns
to
scale
assumption
was
used
and data envelopment analysis was conduct with the DEAP 2.1. In the
second stage, a Tobit regression analysis conducted on STATA-14 and p-value <5
was used to identify the level of association of the significant variables.
Results: The mean overall technical efficiency, pure technical efficiency and scale
efficiency of the facilities were 0.741, 0.920 and 0.795 respectively. Six (50%) and
5(41.67%) of the hospitals were technical and scale efficient respectively. Three
(25%) of them were operating beyond their scale and need to decrease their scale
of operation to become efficient whereas 4(33.33%) of the others were operating
below their level need to increase their scale of operation to become efficient.
Conclusions: In this study half of public hospitals in the northwest Amhara were
technical efficient with the mean pure technical efficiency of the facilities more than
ninety percent. The study also showed that heads not as such young, service year
of the facility and presence of another health facility were positively whereas
bachelor holder heads’ and catchment population negatively associated with the
technical efficiency score of hospitals.
Key words: Technical efficiency, Maternal health, Public hospitals, DEA, Amhara
