Biomedical subjects

Eyob Zere

Publications and source records attributed to Eyob Zere.

3 recordsLinked to original sources

PubMed2006

Technical efficiency of district hospitals: evidence from Namibia using data envelopment analysis.

BACKGROUND: In most countries of the sub-Saharan Africa, health care needs have been increasing due to emerging and re-emerging health problems. However, the supply of health care resources to address the problems has been continuously declining, thus jeopardizing the progress towards achieving the health-related Millennium Development Goals. Namibia is no exception to this. It is therefore necessary to quantify the level of technical inefficiency in the countries so as to alert policy makers of the potential resource gains to the health system if the hospitals that absorb a lion's share of the available resources are technically efficient. METHOD: All public sector hospitals (N = 30) were included in the study. Hospital capacity utilization ratios and the data envelopment analysis (DEA) technique were used to assess technical efficiency. The DEA model used three inputs and two outputs. Data for four financial years (1997/98 to 2000/2001) was used for the analysis. To test for the robustness of the DEA technical efficiency scores the Jackknife analysis was used. RESULTS: The findings suggest the presence of substantial degree of pure technical and scale inefficiency. The average technical efficiency level during the given period was less than 75%. Less than half of the hospitals included in the study were located on the technically efficient frontier. Increasing returns to scale is observed to be the predominant form of scale inefficiency. CONCLUSION: It is concluded that the existing level of pure technical and scale inefficiency of the district hospitals is considerably high and may negatively affect the government's initiatives to improve access to quality health care and scaling up of interventions that are necessary to achieve the health-related Millennium Development Goals. It is recommended that the inefficient hospitals learn from their efficient peers identified by the DEA model so as to improve the overall performance of the health system.

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PubMed2003

Inequities in under-five child malnutrition in South Africa.

OBJECTIVES: To assess and quantify the magnitude of inequalities in under-five child malnutrition, particularly those ascribable to socio-economic status and to consider the policy implications of these findings. METHODS: Data on 3765 under-five children were derived from the Living Standards and Development Survey. Household income, proxied by per capita household expenditure, was used as the main indicator of socio-economic status. Socio-economic inequality in malnutrition (stunting, underweight and wasting) was measured using the illness concentration index. The concentration index was calculated for the whole sample, as well as for different population groups, areas of residence (rural, urban and metropolitan) and for each province. RESULTS: Stunting was found to be the most prevalent form of malnutrition in South Africa. Consistent with expectation, the rate of stunting is observed to be the highest in the Eastern Cape and the Northern Province - provinces with the highest concentration of poverty. There are considerable pro-rich inequalities in the distribution of stunting and underweight. However, wasting does not manifest gradients related to socio-economic position. Among White children, no inequities are observed in all three forms of malnutrition. The highest pro-rich inequalities in stunting and underweight are found among Coloured children and metropolitan areas. There is a tendency for high pro-rich concentration indices in those provinces with relatively lower rates of stunting and underweight (Gauteng and the Western Cape). CONCLUSION: There are significant differences in under-five child malnutrition (stunting and underweight) that favour the richest of society. These are unnecessary, avoidable and unjust. It is demonstrated that addressing such socio-economic gradients in ill-health, which perpetuate inequalities in the future adult population requires a sound evidence base. Reliance on global averages alone can be misleading. Thus there is a need for evaluating policies not only in terms of improvements in averages, but also improvements in distribution. Furthermore, addressing problems of stunting and underweight, which are found to be responsive to improvements in household income status, requires initiatives that transcend the medical arena.

Journal Article↗

PubMed2003

Equity in self-reported adult illness and use of health service in South Africa: inter-temporal comparison.

The study was carried out to assess the magnitude of, and change in, inequities in self-reported adult illness and use of healthcare and to consider the policy implications of the findings. Datasets from three household surveys carried out in 1993, 1995, and 1998 were used. Inequities were measured using illness and healthcare-use concentration indices. Self-reported adult illness was greater among the rich in 1993, but this was reversed to reflect higher levels of reported illness among the poor in 1995 and 1998. Inequities were observed in self-reported injury and disability/chronic illness that favour the rich. The poor also reported more days of sickness compared to the rich. Overall, there were higher levels of use of doctors and hospital services by the rich, relative to their levels of reported illness. In contrast, there was a greater use of public-sector facilities by the poor. The time taken to reach a health facility also had a bias in favour of the rich. Although there were some favourable changes in the levels of inequities between the three time periods, there still remained considerable inequities that favoured the rich in self-reported adult illness and use of health services that need to be addressed. The consequences of higher concentration of chronic illness/disability and injury among the poor have far-reaching negative consequences on the socioeconomic welfare of the individuals and households. Redressing these inequities needs a holistic strategy that transcends the health sector.

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