Doris Kirigia

Technical efficiency of peripheral health units in Pujehun district of Sierra Leone: a DEA application

BackgroundThe Data Envelopment Analysis (DEA) method has been fruitfully used in many countries in Asia, Europe and North America to shed light on the efficiency of health facilities and programmes. There is, however, a dearth of such studies in countries in sub-Saharan Africa. Since hospitals and health centres are important instruments in the efforts to scale up pro-poor cost-effective interventions aimed at achieving the United Nations Millennium Development Goals, decision-makers need to ensure that these health facilities provide efficient services. The objective of this study was to measure the technical efficiency (TE) and scale efficiency (SE) of a sample of public peripheral health units (PHUs) in Sierra Leone.MethodsThis study applied the Data Envelopment Analysis approach to investigate the TE and SE among a sample of 37 PHUs in Sierra Leone.ResultsTwenty-two (59%) of the 37 health units analysed were found to be technically inefficient, with an average score of 63% (standard deviation = 18%). On the other hand, 24 (65%) health units were found to be scale inefficient, with an average scale efficiency score of 72% (standard deviation = 17%).ConclusionIt is concluded that with the existing high levels of pure technical and scale inefficiency, scaling up of interventions to achieve both global and regional targets such as the MDG and Abuja health targets becomes far-fetched. In a country with per capita expenditure on health of about US

Economic burden of cholera in the WHO African region

7, and with only 30% of its population having access to health services, it is demonstrated that efficiency savings can significantly augment the governments initiatives to cater for the unmet health care needs of the population. Therefore, we strongly recommend that Sierra Leone and all other countries in the Region should institutionalise health facility efficiency monitoring at the Ministry of Health headquarter (MoH/HQ) and at each health district headquarter.

Community perceptions of health insurance and their preferred design features: implications for the design of universal health coverage reforms in Kenya

BackgroundIn 2007, various countries around the world notified 178677 cases of cholera and 4033 cholera deaths to the World Health Organization (WHO). About 62% of those cases and 56.7% of deaths were reported from the WHO African Region alone. To date, no study has been undertaken in the Region to estimate the economic burden of cholera for use in advocacy for its prevention and control. The objective of this study was to estimate the direct and indirect cost of cholera in the WHO African Region.MethodsDrawing information from various secondary sources, this study used standard cost-of-illness methods to estimate: (a) the direct costs, i.e. those borne by the health-care system and the family in directly addressing cholera; and (b) the indirect costs, i.e. loss of productivity caused by cholera, which is borne by the individual, the family or the employer. The study was based on the number of cholera cases and deaths notified to the World Health Organization by countries of the WHO African Region.ResultsThe 125018 cases of cholera notified to WHO by countries of the African Region in 2005 resulted in a real total economic loss of US

Assessing the feasibility of eHealth and mHealth: a systematic review and analysis of initiatives implemented in Kenya

39 million, US

I've got 99 problems but a phone ain't one: Electronic and mobile health in low and middle income countries

53.2 million and US

The essence of governance in health development.

64.2 million, assuming a regional life expectancies of 40, 53 and 73 years respectively. The 203,564 cases of cholera notified in 2006 led to a total economic loss US

Indirect costs associated with deaths from the Ebola virus disease in West Africa

91.9 million, US

Inequalities in selected health-related Millennium Development Goals indicators in all WHO Member States

128.1 million and US

Counting the cost of child mortality in the World Health Organization African region.

156 million, assuming life expectancies of 40, 53 and 73 years respectively. The 110,837 cases of cholera notified in 2007 resulted in an economic loss of US

Technical efficiency of human resources for health in Africa

43.3 million, US