Effect of armed conflicts on humanitarian operations: Total factor productivity and efficiency of rural hospitals

Abstract

We study an important but widely neglected topic in humanitarian operations: armed conflicts. Specifically, this paper empirically analyzes the effect of armed conflicts on the operational performance of first-layer response organizations. Using as a case study the Colombian conflict we investigate the effect of conflict on public rural hospitals' (i) total factor productivity, (ii) efficiency and (iii) efficiency variability. The panel data set (2007e2011) used in this study includes information at the hospital level for 163 hospitals and qualitative data collected from interviews with medical staff from the Colombian Ministry of Health and hospitals in different conflict zones. Our results indicate that armed conflict has a positive effect on total factor productivity, while it has a negative impact on hospital efficiency, and interestingly that efficiency and total factor productivity both increase in post conflict. Finally, the results show that efficiency variability is higher in peace and post-conflict hospitals and lower in medium and severe-conflict hospitals. These results have operations management implications and opportunities for future research related to sourcing decisions, supply chain and workforce flexibility, behavioral impacts on the workforce, and humanitarian response to conflicts.

Empirically grounded research in humanitarian operations management: The way forward

“…Similarly, donor fragmentation is shown to be a contextual characteristic negatively impacting managerial efficiency. Clearly, as in Jola‐Sánchez et al. (2016), armed conflicts strongly affect how hospitals and medical staff operate.…”

“…Others like Berenguer et al. (2016) and Jola‐Sánchez et al. (2016) use data envelopment analysis to determine efficient frontiers between operational units.…”

“…Interestingly, the findings show that intensity of conflict has a positive effect on total factor productivity. According to the authors, this may be due to unobservable aspects that include “ speed‐up, managerial ability, knowledge accumulation and specialization effects ” (Jola‐Sánchez et al., 2016). Moreover, both total factor productivity and efficiency increase in post conflict hospitals.…”

From efficiency‐driven to low‐carbon operations management: Implications for labor productivity

“…A feasible estimator to address this omitted variable bias is the well‐known first‐difference (FD) estimator, which results from a transformation process of the original equation by taking the first differences for all variables. The fixed effects estimator represents a very close alternative to FD but with the necessary assumption of serially uncorrelated residuals, which may be too strong (Jola‐Sanchez, Pedraza‐Martinez, Bretthauer, & Britto, ). Instead, the FD estimator assumes that the first differences of the idiosyncratic errors are serially uncorrelated (Wooldridge, , 317).…”

Distribution of Medication Considering Information, Transshipment, and Clustering: Malaria in Malawi

“…While we do not directly study funding mechanisms, we do analyze the impact of different levels of funding on supply chain performance. Other mechanisms that affect the delivery of humanitarian operations include earmarked funding, Besiou et al (2014), and armed conflict, Jola-Sanchez et al (2016). In the case of Malawi, the latter has never been a major issue and the former does not have much impact on malaria medication distribution, but nonetheless are important to consider in the broader context of global health operations.…”