Efficiency of health facilities providing antiretroviral treatment services in Botswana

Abstract

Background: Botswana is implementing an ambitious universal health coverage agenda and successfully expanding antiretroviral treatment to nearly 380,000 people living with human immunodeficiency virus (HIV). However, the country needs to critically assess its efficient use of all available resources to sustain gains and continue progress to attain the targets and vision for ending acquired immune deficiency syndrome (AIDS) as a public health threat by 2030. The objective of this study was to measure costs and efficiency of antiretroviral therapy (ART) provision in Botswana's public facilities, and to identify opportunities for potential savings in order to expand ART coverage. Methods:We applied an activity-based costing approach to a random sample of 2,393 adults receiving ART outpatient services in 120 facilities in Botswana. All costs are reported in 2017 US$. We defined efficiency as the amount of resources that is put into the delivery of healthcare in relation to the amount of people receiving services. Employing a health systems perspective, the production of antiretroviral healthcare services includes three major inputs: labor, antiretroviral drugs and laboratory tests. The production unit was defined as an ART clinical unit running in a hospital, primary health care (PHC) clinic, or health post.Data envelopment analysis (DEA) was used to identify the most efficient facilities and regression analysis to identify factors associated with technical efficiency.

Review of the use of R Programming for Data Analysis in Botswana Research

“…There has been numerous research conducted in Botswana in order to improve the efficiency of health facilities by addressing potential barriers. [14]has said Botswana is implementing an ambitious universal health coverage agenda and successfully expanding antiretroviral treatment to nearly 380,000 people living with human immunodeficiency virus (HIV). However, the country needs to critically assess its efficient use of all available resources to sustain gains and continue progress to attain the targets and vision for ending acquired immune deficiency syndrome (AIDS) as a public health threat by 2030.…”