Disentangling the efficiency drivers in country‐level global health programs: An empirical study

Abstract

Motivated by the cost reductions and outcome improvements generated by benchmarking in many industries, we focus on in-country global health programs to identify and quantify opportunities for process improvement. We empirically study the major efficiency drivers of reproductive health (RH) country programs in Sub-Saharan Africa sponsored by international funding organizations. To ensure a level playing field for comparison across countries, we quantify the impact of cross-country heterogeneity and random shocks on the efficiency of RH programs. To analyze these relationships and isolate the effects attributable to managerial inefficiency, we use a three-stage Data Envelopment Analysis (DEA)/ Stochastic Frontier Analysis (SFA) model. We show the impact of environmental factors on program efficiency, linking policy making decisions with operational and health outcome performance. We also show that donor fragmentation negatively impacts managerial efficiency, and we suggest actions to mitigate this effect. We then provide a way to improve performance through benchmarking efforts within groups of countries and present an initial prototype of such efforts.

National Drug Stockout Risks and the Global Fund Disbursement Process for Procurement

“…Given the heterogeneity of countries within these regions along many dimensions however (Berenguer et al. ), this explanation does not seem plausible. Rather, we have used for this analysis the exact definition of geographic regions used by the Global Fund for reporting purposes, and these regions are also reflected in its internal organizational structure—for example, fund portfolio managers are almost always responsible for countries within a single region.…”

“…It is possible that these geographic regions should actually coincide with some intrinsic features of recipient countries that would similarly affect the processes used for grant performance evaluations and disbursements. Given the heterogeneity of countries within these regions along many dimensions however (Berenguer et al 2016), this explanation does not seem plausible. Rather, we have used for this analysis the exact definition of geographic regions used by the Global Fund for reporting purposes, and these regions are also reflected in its internal organizational structure-for example, fund portfolio managers are almost always responsible for countries within a single region.…”

Empirically grounded research in humanitarian operations management: The way forward

“…Most papers in this special issue focus on how the specific context impacts the decision space and conclusions. For instance, Berenguer et al. (2016) deal with how context drives behavior and decisions.…”

“…As in Berenguer et al. (2016), Data Envelopment Analysis is used to estimate the efficiency of each hospital and establish an efficient frontier.…”

Reliability and economic analysis and improvement of complex mechanical products based on DEA: An empirical case study of hydraulic products

“…7 DEA uses linear programming to permit individual DMU to choose weights associated with inputs and outputs that would maximize their efficiency. 8 Currently, the DEA technique has been employed in many industries, including the cost efficiency analysis of bank branch performance, 9 the sewage treatment plants, 10 the airport, 11 the environmental efficiency analysis, 12 and so on.…”