Scaling up Maternal and Child Healthcare Delivery among Mission Hospitals in Southeast Nigeria: An Empirical Application of Data Envelopment Analysis for Setting Benchmarks and Targets

The health system in many parts of Nigeria has been dysfunctional in several domains including financing, human resources, infrastructure, health management information system and hospital services. In an attempt to scale up Maternal and Child Health (MCH) services and ensure efficiency, Ebonyi State Government in Southeast Nigeria provided funding to mission hospitals across the State as a grant. This study used nonparametric method to assess the effect of this public financing on the efficiency of the mission hospitals. Operational cost and number of hospital beds were used as the input variables, while antenatal registrations, number of immunization doses and hospital deliveries were the output variables. The hospitals were disaggregated into 15 hospital-years. The mean overall technical efficiency of the mission hospitals was 84.05±22.45%. The mean pure technical efficiency was 95.56±6.9% and the scale efficiency was 88.05±22.20%. About 46.67% of all the hospital-years were technically and scale efficient. Although, 55.33% were generally inefficient, only 33.33% of hospital-years exhibited pure technical inefficiency. Low immunization coverage was the major cause of inefficiency. The study showed increased maternal health service output as result of public funding or intervention; however, the mission hospitals could have saved 16% of input resources if they had performed efficiently. It also shows that data envelopment analysis can be used in setting targets/benchmarks for relatively inefficient health facilities, and in monitoring impact of interventions on efficiency of hospitals over-time. (Afr J Reprod Health 2019; 23[3]: 57-67). Dans de nombreuses régions du Nigéria, le système de santé est dysfonctionnel dans plusieurs domaines, notamment le financement, les ressources humaines, les infrastructures, le système d'information sur la gestion de la santé et les services hospitaliers. Dans le but de renforcer les services de santé maternelle et infantile et d'assurer l'efficacité, le gouvernement de l'État d'Ebonyi, dans le sud-est du Nigéria, a octroyé une subvention aux hôpitaux des missions de l'État. Cette étude a utilisé une méthode non paramétrique pour évaluer l'effet de ce financement public sur l'efficacité des hôpitaux de mission. Le coût opérationnel et le nombre de lits d'hôpitaux ont été utilisés comme variables d'entrée, tandis que les variables de sortie étaient les enregistrements prénatals, le nombre de doses d'immunisation et les ac