Efficiency of the Ethiopian Health Extension Program: An Application of Data Envelopment Analysis
Keywords:Data envelopment analysis; Efficiency; Ethiopia; Health extension workers; Health posts; Region
This study aims at evaluating the relative technical efficiency and productivity of the Ethiopian rural health extension program, with an emphasis on rural health posts, using Data Envelopment Analysis and the Malmquist index for data obtained from regional health bureaus in Ethiopia, covering 1,552 health posts for the period 2013-2014. We also examine factors associated with technical inefficiency variations across health posts using the Tobit regression model. Our findings indicate that about 5.67 percent of health posts are technically efficient. Estimated technical and scale efficiency levels of health posts vary across regions and most of them exhibit decreasing returns to scale. The examined health posts improved their productivity by 22.9 percent because of technological progress. Furthermore, supportive supervision, the average distance from health posts to households’ residence, the religion and region of residence of health extension workers, were the major determinants of technical inefficiency variations across health posts. Hence, this study confirms the existence of variations in technical and scale efficiencies of health posts across and within regions, suggesting potential for improving efficiency. We, therefore recommend that the Ethiopian health posts need to augment their scale size and improve their managerial practices to enhance their overall efficiency and productivity.