TECHNICAL EFFICIENCY OF PUBLIC HOSPITALS ON PROVISION OF MATERNAL HEALTH SERVICES AND ASSOCIATED FACTORS AT NORTHWEST OF AMHARA NATIONAL REGIONAL STATE, ETHIOPIA

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