Efficiency Of Health System Units In Africa

Despite sending huge sums of money on health every year the African region's burden of disease is persistently high. Most of the countries in the region are lagging behind in achieving the health-related United Nations Millennium Development Goals. The African region's dismal health situation has largely been blamed on weakness pertaining to such factors as health leadership and governance; service delivery; health workforce; medicines, vaccines, and health technologies; health information; and health system financing that have undermined the capacity of health systems of countries in the region to improve population health without wastage of resources. Institutionalising health system efficiency monitoring, as a basis for the design and implementation of appropriate policy interventions, has been proposed as an effective way of curbing wastage of health system inputs. Efficiency of Health System Units in Africa: A Data Envelopment Analysis is the first book of its kind on application of the data envelopment analysis technique to examine the efficiency of health system decision-making units in Africa. The book interlaces lecture notes with research articles and case studies to equip students and practitioners of economics, operations research, management science, and public health with knowledge and skills for undertaking technical efficiency, cost efficiency, and total factor productivity analyses.

Drawing on various disciplinary perspectives, this book re-focuses the debate on what makes a good health system, with a view to clarifying the uses of social science research in thinking about health care issues in Africa. The explosion of the HIV/AIDS pandemic, the persistence of malaria as a major killer, and the resurgence of diseases like tuberculosis which were previously under control, have brought about changes in the health system, with implications for its governance, especially in view of the diminished capacity of the public health facilities to cope with a complex range of expanded needs. Government responsibilities and objectives in the health sector have been redefined, with private sector entities (both for profit and not-for profit) playing an increasingly visible role in health care provisions. The reasons for collaborative patterns vary, but chronic under-funding of publicly financed health services is often an important factor. Processes of decentralisation and health sector reforms have had mixed effects on health care system performance; while private health insurance markets and private clinics are pointers to a growing stratification of the health market, in line with the intensified income and social differentiation that has occurred over the last two decades.These developments call for health sector reforms.

In this book the authors explore the state of the art on efficiency measurement in health systems and international experts offer insights into the pitfalls and potential associated with various measurement techniques. The authors show that: - The core idea of efficiency is easy to understand in principle - maximizing valued outputs relative to inputs, but is often difficult to make operational in real-life situations - There have been numerous advances in data collection and availability, as well as innovative methodological approaches that give valuable insights into how efficiently health care is delivered - Our simple analytical framework can facilitate the development and interpretation of efficiency indicators.

The challenges to better health services in Africa are well known: Africa lags behind all regions of the world, including other developing regions, on all indicators of better health. A recent report from the World Health Organisation for instance shows that while Africa has 20% of the world's sick people, it has only 4% of its healthcare workers - many of them vulnerable to the high mortality rate associated with malaria and notably the AIDS epidemic. The state of investment in healthcare infrastructure is also grossly inadequate as is the efficiency of healthcare delivery. But does this need to be so? What factors are responsible for this unacceptable state of affairs? Contributors to the volume examine the evolution of healthcare services in Africa, the ongoing national, regional and continental efforts to improve the delivery of healthcare in the continent, and the direct and indirect obstacles militating against the maturation of the services and their efficient delivery. The contributors - all distinguished experts in the field, who hold either challenging responsibilities in health in Africa or have worked in multiple components of the healthcare delivery system in the continent - also provide powerful personal insights and lessons learned in their current or previous work in the health sector in Africa. Some of the themes covered include clinical care and centers of excellence, healthcare finance and resource mobilization, primary health care systems and community health; preventive care and risk reduction in health; the role of reference laboratories; clinical research and partnerships, the role of epidemiology, statistics, monitoring and evaluation in health services; the role of the African Diaspora, and the role of politics in the organization of healthcare and the training of medical and other health professionals. From their analyses and experience the authors articulate proven strategies and solutions based on consensus expert opinions on how to improve the quality of health services and health outcomes in the continent.

This book presents contributions to the 50th Annual Conference of the Operations Research Society of South Africa (ORSSA), which was jointly hosted with the African Federation of Operations Research Societies (AFROS) at North-West University in Potchefstroom, South Africa from 12 to 15 September, 2021. Focusing on innovative case studies and recent applications of Operations Research models and algorithms in African countries, each chapter highlights findings emerging from the countries in question and explains the lessons learned. As such, the book offers an up-to-date overview of Operations Research practices and developments in Africa. AFROS is a “not for profit” organization that aims to promote Operations Research in Africa. Its affairs are regulated by an Executive Committee consisting of representatives/alternates of all its member societies. The members of the Federation undertake to co-operate in the advancement of knowledge, interest and education in Operations Research by appropriate means, particularly the exchange of information, the holding of meetings and conferences, and the awarding of prizes.

World Bank Discussion Paper No. 385. Since the advent of reform in 1992, the Russian authorities have made substantial strides toward creating a market economy through privatization. Recently, Russian authorities have established an institutional framework for a case-by-case approach that ensures transparency and competition through the use of independent financial and other advisers. This paper contains the principal presentations made at a World Bank workshop on the lessons of international experience in case-by-case privatization.

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"This book examines some of the most important techniques currently available to measure the efficiency of systems and organisations, including data envelopment analysis and stochastic frontier analysis, and also presents some promising new methodological approaches." [Title verso].