Technical efciency of public health centers in three districts in Ethiopia: two-stage data envelopment analysis

Abstract

Objective: The aim of the study was to measure technical and scale efciency of public health centers in three districts of Jimma zone, Ethiopia. A two-stage data envelopment analysis was used. First, we estimated technical and scale efciency of the health centers. In the second stage, institutional and environmental factors were against techni‑ cal efciency of the health centers to identify factors associated to efciency of the health centers. Results: Eight out of the 16 health centers in the study were found to be technically efcient, with an average score of 90% (standard deviation=17%). This indicates that on average they could have reduce their utilization of all inputs by about 10% without reducing output. On the other hand, 8 out of 16 health centers were found to be scale efcient, with an average scale efciency score of 94% (standard deviation=9%). The inefcient health centers had an average scale score of 89%; implying there is potential for increasing total outputs by about 11% using the existing capacity/size. Catchment population and number of clinical staf were found to be directly associated with efciency, while the number of nonclinical staf was found to be inversely associated with efciency.