Stochastic frontier approach to efficiency analysis of health facilities in providing services for non-communicable diseases in eight LMICs.

Abstract

The rising burden of non-communicable diseases presents an increasing public health challenge to many low- and middle-income countries. This problem may be compounded in health systems with lower levels of technical efficiency (TE). This study used recent Service Provision Assessments data to estimate the level of TEs of health facilities in eight countries. Initially, the general and disease-specific service readiness indexes are estimated. Finally, the production function is estimated using the exposures and the outcomes of the model. Evidence shows that the general and disease-specific service readiness indexes are significantly associated with an increase in the number of outpatient visits. Outpatient visits may increase by 14% with an increase in health worker density. Similarly, outpatient visits may increase by 0.3% with a unit increase in the general and diabetes service readiness indexes. Furthermore, outpatient visits may increase by 0.4% and 0.8% with an increase in services readiness for cardiovascular and respiratory diseases. respectively. Overall, the level of TE score suggests the need for improvement. Facility-level service readiness for chronic diseases is quite low. Therefore, improving health outcomes related to chronic diseases requires urgent investment in high-quality health systems in these countries.