Efficiency of the Maternal & Child Health Care Services in Punjab, Pakistan

Abstract

In spite of continuous efforts of Government to improve the health status, progress has not been uniform across the Punjab province of Pakistan. This raises questions related to the performance of health system which needs further investigation. The present study is an attempt to investigate Technical Efficiency (TE) and Scale Efficiency (SE) in the delivery of maternal and child health services in the 36 districts of Punjab for the period 2011 and 2014 using double bootstrap DEA approach. Under 5 Mortality Rates (U5MR) and Maternal Mortality Rate (MMR) have been used as proxies of health status and hospitals, beds, doctors, nurses and other staff are taken as a set of health system inputs. The effects of socio-environmental factors on efficiencies, which are beyond the control of health system decision makers, also have been measured by using truncated regression. The results of the study suggest that average technical and scale efficiencies with respect to reducing U5MR and MMR are 68% and 91% in 2011, 76% and 93% in 2014 respectively. It suggests that in Punjab there exists a huge technical efficiency but minor scale inefficiency in the utilization of resources. This indicates that there is an improvement in the performance of the districts of Punjab from 2011 to 2014. The results of second stage suggest that all socio environmental factors have significant impact on efficiencies.