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29.05.2024

Assessing efficiency maternal and child health services in Morocco: data envelopement analysis and Tobit model

verfasst von: Youssef Er-Rays, Meriem M’dioud, Hamid Ait-Lemqeddem, Mustapha Ezzahiri

Erschienen in: Quality & Quantity | Ausgabe 6/2024

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Abstract

Efficiency analysis of the Maternal, Newborn, and Child Services Network (MNCSN) is crucial for achieving SDG 2030. However, the mortality rates of maternal, newborn, and child have not reduced since 2018, and there have been limited studies conducted in Morocco on this subject. This study aims to analyze the technical efficiency of 82 MNCSN across primary healthcare Establishments Network (PHCEN) in Morocco in 2021 and identify factors influencing their efficiency. Technical efficiency was estimated using the Data Envelopment Analysis (DEA) method with an input orientation. Tobit regression was employed to analyze factors affecting the technical efficiency of maternal and child healthcare. In the initial stage, the average efficiency score of the 82 MNCSN was 0.779 for constant returns, with 36 MNCSN achieving a score of 1. However, the Boujdour MNCSN recorded the lowest efficiency score of 0.033. In the second stage, Tobit regression revealed that Model 2 was more significant than Model 1. Specifically, the explanatory variable Rural Dispensary exhibited strong statistical significance and a positive impact on maternal and child health, followed by variables such as High-risk Pregnancies Supported and High-risk Pregnancies. The study findings suggest that the resources allocated for MNCSN in Morocco are not being efficiently utilized compared to some other African and European countries. Therefore, the Ministry of Health in Morocco should review the functions of MNCSN, aiming to improve the delivery of maternal, newborn, and child healthcare, regardless of the setting, be it urban or rural.

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Literatur
Zurück zum Zitat Africa, W.H.O.R.O. for: Technical efficiency of health systems in the WHO African Region. World Health Organization. Regional Office for Africa (2023) Africa, W.H.O.R.O. for: Technical efficiency of health systems in the WHO African Region. World Health Organization. Regional Office for Africa (2023)
Zurück zum Zitat Ahmadabadi, H.Z., Masoudian, S., Banadkouki, M.R.Z.: Evaluating the technical efficiency of Yazd City health centers with a combined approach of DEA and GT. Majallah- Dānishgāh- ’ulūm- Pizishkī- Shahīd Ṣadūqī Yazd 26, 717–732 (2019) Ahmadabadi, H.Z., Masoudian, S., Banadkouki, M.R.Z.: Evaluating the technical efficiency of Yazd City health centers with a combined approach of DEA and GT. Majallah- Dānishgāh- ’ulūm- Pizishkī- Shahīd Ṣadūqī Yazd 26, 717–732 (2019)
Zurück zum Zitat Akazili, J., Adjuik, M., Chatio, S., Kanyomse, E., Hodgson, A., Aikins, M., Gyapong, J.: What are the technical and allocative efficiencies of public health centres in Ghana? Ghana Med. J. 42, 149–155 (2008) Akazili, J., Adjuik, M., Chatio, S., Kanyomse, E., Hodgson, A., Aikins, M., Gyapong, J.: What are the technical and allocative efficiencies of public health centres in Ghana? Ghana Med. J. 42, 149–155 (2008)
Zurück zum Zitat Alhassan, R.K., Nketiah-Amponsah, E., Akazili, J., Spieker, N., Arhinful, D.K., Rinke de Wit, T.F.: Efficiency of private and public primary health facilities accredited by the National Health Insurance Authority in Ghana. Cost Eff. Resour. Alloc. CE 13, 23 (2015). https://doi.org/10.1186/s12962-015-0050-zCrossRef Alhassan, R.K., Nketiah-Amponsah, E., Akazili, J., Spieker, N., Arhinful, D.K., Rinke de Wit, T.F.: Efficiency of private and public primary health facilities accredited by the National Health Insurance Authority in Ghana. Cost Eff. Resour. Alloc. CE 13, 23 (2015). https://​doi.​org/​10.​1186/​s12962-015-0050-zCrossRef
Zurück zum Zitat Amirteimoori, A., Sahoo, B.K., Charles, V., Mehdizadeh, S.: An Introduction to Data Envelopment Analysis, in: Amirteimoori, A., Sahoo, B.K., Charles, V., Mehdizadeh, S. (Eds.), Stochastic Benchmarking: Theory and Applications, International Series in Operations Research & Management Science. Springer International Publishing, Cham, pp. 13–29 (2022). https://doi.org/10.1007/978-3-030-89869-4_2 Amirteimoori, A., Sahoo, B.K., Charles, V., Mehdizadeh, S.: An Introduction to Data Envelopment Analysis, in: Amirteimoori, A., Sahoo, B.K., Charles, V., Mehdizadeh, S. (Eds.), Stochastic Benchmarking: Theory and Applications, International Series in Operations Research & Management Science. Springer International Publishing, Cham, pp. 13–29 (2022). https://​doi.​org/​10.​1007/​978-3-030-89869-4_​2
Zurück zum Zitat Benfethllah, R.: Social Dashboard in Morocco. Ministry of Economy, Finance, and Administrative Reform (2020) Benfethllah, R.: Social Dashboard in Morocco. Ministry of Economy, Finance, and Administrative Reform (2020)
Zurück zum Zitat CESE.: Basic health care: towards equitable and widespread access: (No. Saisine n° 4/2013). Economic, Social and Environmental Council, Rabat (2013) CESE.: Basic health care: towards equitable and widespread access: (No. Saisine n° 4/2013). Economic, Social and Environmental Council, Rabat (2013)
Zurück zum Zitat Chen, Y., Cook, W.D., Kao, C., Zhu, J.: Network DEA Pitfalls: Divisional Efficiency and Frontier Projection, in: Cook, W.D., Zhu, J. (Eds.), Data Envelopment Analysis: A Handbook on the Modeling of Internal Structures and Networks, International Series in Operations Research & Management Science. Springer US, Boston, MA, pp. 31–54 (2014). https://doi.org/10.1007/978-1-4899-8068-7_2 Chen, Y., Cook, W.D., Kao, C., Zhu, J.: Network DEA Pitfalls: Divisional Efficiency and Frontier Projection, in: Cook, W.D., Zhu, J. (Eds.), Data Envelopment Analysis: A Handbook on the Modeling of Internal Structures and Networks, International Series in Operations Research & Management Science. Springer US, Boston, MA, pp. 31–54 (2014). https://​doi.​org/​10.​1007/​978-1-4899-8068-7_​2
Zurück zum Zitat Coelli, T.: A guide to DEAP version 2.1: a data envelopment (computer) program. Cent. Effic. Product. Anal. Univ. N. Engl. Armidale NSW Aust (1996) Coelli, T.: A guide to DEAP version 2.1: a data envelopment (computer) program. Cent. Effic. Product. Anal. Univ. N. Engl. Armidale NSW Aust (1996)
Zurück zum Zitat Coelli, T.J., Prasada Rao, D.S., O’Donnell, C.J., Battese, G.E. (Eds.): The Calculation and Decomposition of Productivity Change Using Frontier Methods, in: An Introduction to Efficiency and Productivity Analysis. Springer US, Boston, MA, pp. 289–310 (2005b). https://doi.org/10.1007/0-387-25895-7_11 Coelli, T.J., Prasada Rao, D.S., O’Donnell, C.J., Battese, G.E. (Eds.): The Calculation and Decomposition of Productivity Change Using Frontier Methods, in: An Introduction to Efficiency and Productivity Analysis. Springer US, Boston, MA, pp. 289–310 (2005b). https://​doi.​org/​10.​1007/​0-387-25895-7_​11
Zurück zum Zitat Cooper, W.W., Seiford, L.M., Tone, K.: Returns to Scale, in: Cooper, W.W., Seiford, L.M., Tone, K. (Eds.), Data Envelopment Analysis: A Comprehensive Text with Models, Applications, References and DEA-Solver Software. Springer US, New York, NY, pp. 131–176 (2007). https://doi.org/10.1007/978-0-387-45283-8_5 Cooper, W.W., Seiford, L.M., Tone, K.: Returns to Scale, in: Cooper, W.W., Seiford, L.M., Tone, K. (Eds.), Data Envelopment Analysis: A Comprehensive Text with Models, Applications, References and DEA-Solver Software. Springer US, New York, NY, pp. 131–176 (2007). https://​doi.​org/​10.​1007/​978-0-387-45283-8_​5
Zurück zum Zitat Ferraz, D., Mariano, E.B., Manzine, P.R., Moralles, H.F., Morceiro, P.C., Torres, B.G., de Almeida, M.R., Soares de Mello, J.C., Rebelatto, D.A., do N.,: COVID health structure index: the vulnerability of brazilian microregions. Soc. Indic. Res. 158, 197–215 (2021). https://doi.org/10.1007/s11205-021-02699-3CrossRef Ferraz, D., Mariano, E.B., Manzine, P.R., Moralles, H.F., Morceiro, P.C., Torres, B.G., de Almeida, M.R., Soares de Mello, J.C., Rebelatto, D.A., do N.,: COVID health structure index: the vulnerability of brazilian microregions. Soc. Indic. Res. 158, 197–215 (2021). https://​doi.​org/​10.​1007/​s11205-021-02699-3CrossRef
Zurück zum Zitat Health, M.: Report : Health statistics 2020,2019, 2018, 2017, 2016, 2015, 2014, 2013 and 2012. Rabat- Morocco: Ministry of Health (2020). Health, M.: Report : Health statistics 2020,2019, 2018, 2017, 2016, 2015, 2014, 2013 and 2012. Rabat- Morocco: Ministry of Health (2020).
Zurück zum Zitat Huguenin, J.: Data Envelopment Analysis (DEA) : un guide pédagogique à l’intention des décideurs dans le secteur public (2013). Huguenin, J.: Data Envelopment Analysis (DEA) : un guide pédagogique à l’intention des décideurs dans le secteur public (2013).
Zurück zum Zitat Kirigia, J.M., Sambo, L.G., Renner, A., Alemu, W., Seasa, S., Bah, Y.: Technical efficiency of primary health units in Kailahun and Kenema Districts of Sierra Leone. In: Efficiency of Health System Units in Africa: A Data Envelopment Analysis. pp. 239–265 (2013). Kirigia, J.M., Sambo, L.G., Renner, A., Alemu, W., Seasa, S., Bah, Y.: Technical efficiency of primary health units in Kailahun and Kenema Districts of Sierra Leone. In: Efficiency of Health System Units in Africa: A Data Envelopment Analysis. pp. 239–265 (2013).
Zurück zum Zitat Mbau, R., Musiega, A., Nyawira, L., Tsofa, B., Mulwa, A., Molyneux, S., Maina, I., Jemutai, J., Normand, C., Hanson, K., Barasa, E.: Analysing the efficiency of health systems: a systematic review of the literature. Appl. Health Econ. Health Policy 21, 205–224 (2023). https://doi.org/10.1007/s40258-022-00785-2CrossRef Mbau, R., Musiega, A., Nyawira, L., Tsofa, B., Mulwa, A., Molyneux, S., Maina, I., Jemutai, J., Normand, C., Hanson, K., Barasa, E.: Analysing the efficiency of health systems: a systematic review of the literature. Appl. Health Econ. Health Policy 21, 205–224 (2023). https://​doi.​org/​10.​1007/​s40258-022-00785-2CrossRef
Zurück zum Zitat Ministry, H.: Health Card from the Ministry of Health in Morocco (Carte Sanitaire du ministère de la Santé au Maroc) (2023) Ministry, H.: Health Card from the Ministry of Health in Morocco (Carte Sanitaire du ministère de la Santé au Maroc) (2023)
Zurück zum Zitat Ministry of Health, and S.P.: Performance Project: Finance Laws 2020. Ministry of Health and Social Protection (2020) Ministry of Health, and S.P.: Performance Project: Finance Laws 2020. Ministry of Health and Social Protection (2020)
Zurück zum Zitat Ministry of Health, and S.P.: National integrated child health policy by 2030. Ministry of Health and Social Protection (2019) Ministry of Health, and S.P.: National integrated child health policy by 2030. Ministry of Health and Social Protection (2019)
Zurück zum Zitat Ministry of Health and Social Protection: HEALTH IN FIGURES 2021, Ministry of Health and Social Protection, specifically from the Directorate of Planning and Financial Resources, Morocco (2021) Ministry of Health and Social Protection: HEALTH IN FIGURES 2021, Ministry of Health and Social Protection, specifically from the Directorate of Planning and Financial Resources, Morocco (2021)
Zurück zum Zitat Ministry of Health, S. of P.: Stratégie Nationale de la Santé Sexuelle et Reproductive 2021–2030 (PNSSR) (2020) Ministry of Health, S. of P.: Stratégie Nationale de la Santé Sexuelle et Reproductive 2021–2030 (PNSSR) (2020)
Zurück zum Zitat Ministry of Health, S. of P.: Guide de Planification Familiale (2019) Ministry of Health, S. of P.: Guide de Planification Familiale (2019)
Zurück zum Zitat Ministry of Health, S. of P.: Guide de Prise en Charge Intègré de l’Enfant (PCIE) (2016) Ministry of Health, S. of P.: Guide de Prise en Charge Intègré de l’Enfant (PCIE) (2016)
Zurück zum Zitat Ministry of Health, S.P.: Health card,Health care offer: Carte sanitaire, Offre de soins de Santé (2020) Ministry of Health, S.P.: Health card,Health care offer: Carte sanitaire, Offre de soins de Santé (2020)
Zurück zum Zitat Mohammadpour, S., Javan-Noughabi, J., Vafaee Najar, A., Zangeneh, M., Yousefi, S., Nouhi, M., Jahangiri, R.: Factors affecting the technical efficiency of rural primary health care centers in Hamadan, Iran: data envelopment analysis and Tobit regression. Cost Eff. Resour. Alloc. 18, 53 (2020). https://doi.org/10.1186/s12962-020-00249-1CrossRef Mohammadpour, S., Javan-Noughabi, J., Vafaee Najar, A., Zangeneh, M., Yousefi, S., Nouhi, M., Jahangiri, R.: Factors affecting the technical efficiency of rural primary health care centers in Hamadan, Iran: data envelopment analysis and Tobit regression. Cost Eff. Resour. Alloc. 18, 53 (2020). https://​doi.​org/​10.​1186/​s12962-020-00249-1CrossRef
Zurück zum Zitat MSISF, M. of S., Social Integration and Family: Integrated Public Policy for Child Protection. Ministry of Solidarity, Social Integration and Family (2013) MSISF, M. of S., Social Integration and Family: Integrated Public Policy for Child Protection. Ministry of Solidarity, Social Integration and Family (2013)
Zurück zum Zitat Odah, M.H.: Asymptotic least squares estimation of tobit regression model. An application in remittances of iraqi immigrants in Romania. Int. J. Stat. Appl. 2, 96 (2018) Odah, M.H.: Asymptotic least squares estimation of tobit regression model. An application in remittances of iraqi immigrants in Romania. Int. J. Stat. Appl. 2, 96 (2018)
Zurück zum Zitat Ogloblin, C.: Health care efficiency across countries: a stochastic frontier analysis. Appl. Econom. Int. Dev. 11, 966 (2011) Ogloblin, C.: Health care efficiency across countries: a stochastic frontier analysis. Appl. Econom. Int. Dev. 11, 966 (2011)
Zurück zum Zitat Oikonomou, N., Tountas, Y., Mariolis, A., Souliotis, K., Athanasakis, K., Kyriopoulos, J.: Measuring the efficiency of the Greek rural primary health care using a restricted DEA model; the case of southern and western Greece. Health Care Manag. Sci. 19, 313–325 (2016). https://doi.org/10.1007/s10729-015-9324-4CrossRef Oikonomou, N., Tountas, Y., Mariolis, A., Souliotis, K., Athanasakis, K., Kyriopoulos, J.: Measuring the efficiency of the Greek rural primary health care using a restricted DEA model; the case of southern and western Greece. Health Care Manag. Sci. 19, 313–325 (2016). https://​doi.​org/​10.​1007/​s10729-015-9324-4CrossRef
Zurück zum Zitat Ravaghi, H., Afshari, M., Isfahani, P., Mahboub-Ahari, A., Bélorgeot, V.D.: Hospital Efficiency in the Eastern Mediterranean Region: A Systematic Review and Meta-Analysis, p. 11. Public Health, Front (2023) Ravaghi, H., Afshari, M., Isfahani, P., Mahboub-Ahari, A., Bélorgeot, V.D.: Hospital Efficiency in the Eastern Mediterranean Region: A Systematic Review and Meta-Analysis, p. 11. Public Health, Front (2023)
Zurück zum Zitat Rays, Y.E.: Data envelopment analysis and malmquist index application: efficiency of primary health care in Morocco and Covid-19. Turk. J. Comput. Math. Educ. TURCOMAT 12, 971–983 (2021)CrossRef Rays, Y.E.: Data envelopment analysis and malmquist index application: efficiency of primary health care in Morocco and Covid-19. Turk. J. Comput. Math. Educ. TURCOMAT 12, 971–983 (2021)CrossRef
Zurück zum Zitat Rays, Y.E., Lemqeddem, H.A.: The performance of basic health care facilities in Morocco and COVID-19: application of data envelopment analysis and the malmquist index. Rev. Fr. Econ. Gest. 1, 65 (2020) Rays, Y.E., Lemqeddem, H.A.: The performance of basic health care facilities in Morocco and COVID-19: application of data envelopment analysis and the malmquist index. Rev. Fr. Econ. Gest. 1, 65 (2020)
Zurück zum Zitat Sachs, Guillaume, Grayson Fuller, Eamon Drum: UNSDSN Sustainable Development Report 2023: Implementing the SDG Stimulus Includes the SDG Index and Dashboards Jeffrey D. Sachs, Guillaume Lafortune, Grayson Fuller and Eamon Drum (2023) Sachs, Guillaume, Grayson Fuller, Eamon Drum: UNSDSN Sustainable Development Report 2023: Implementing the SDG Stimulus Includes the SDG Index and Dashboards Jeffrey D. Sachs, Guillaume Lafortune, Grayson Fuller and Eamon Drum (2023)
Zurück zum Zitat Seiford, L.M.: Data envelopment analysis: the evolution of the state of the art (1978–1995). J. Prod. Anal. 5, 63 (1996) Seiford, L.M.: Data envelopment analysis: the evolution of the state of the art (1978–1995). J. Prod. Anal. 5, 63 (1996)
Zurück zum Zitat Social Protection, M. de la S.: Prise en charge intégrée des problèmes du nouveau-né (PPCPN-N). Moroccan Ministry of Health (2016). Social Protection, M. de la S.: Prise en charge intégrée des problèmes du nouveau-né (PPCPN-N). Moroccan Ministry of Health (2016).
Zurück zum Zitat Unicef- Morocco 1: Child-Related SDG Progress Assessment for Morocco (2021) Unicef- Morocco 1: Child-Related SDG Progress Assessment for Morocco (2021)
Zurück zum Zitat WHO: Monitoring health for the SDGs (2023a) WHO: Monitoring health for the SDGs (2023a)
Zurück zum Zitat WHO: World Health Statistics 2023 (2023b) WHO: World Health Statistics 2023 (2023b)
Zurück zum Zitat WHO: Report of the Global conference on primary health care: from Alma-Ata towards universal health coverage and the Sustainable Development Goals. Astana (2018) WHO: Report of the Global conference on primary health care: from Alma-Ata towards universal health coverage and the Sustainable Development Goals. Astana (2018)
Zurück zum Zitat WHO: Declaration of Alma-Ata. Alma-Ata (1978) WHO: Declaration of Alma-Ata. Alma-Ata (1978)
Zurück zum Zitat WHO, H. (HQ): Health in 2015: from MDGs to SDGs (No. ISBN: 978 92 4 156511 0). World Health Organization (2015) WHO, H. (HQ): Health in 2015: from MDGs to SDGs (No. ISBN: 978 92 4 156511 0). World Health Organization (2015)
Zurück zum Zitat Yitbarek, K., Abraham, G., Adamu, A., Tsega, G., Berhane, M., Hurlburt, S., Mann, C., Woldie, M.: Technical efficiency of neonatal health services in primary health care facilities of Southwest Ethiopia: a two-stage data envelopment analysis. Health Econ. Rev. 9, 27 (2019). https://doi.org/10.1186/s13561-019-0245-7CrossRef Yitbarek, K., Abraham, G., Adamu, A., Tsega, G., Berhane, M., Hurlburt, S., Mann, C., Woldie, M.: Technical efficiency of neonatal health services in primary health care facilities of Southwest Ethiopia: a two-stage data envelopment analysis. Health Econ. Rev. 9, 27 (2019). https://​doi.​org/​10.​1186/​s13561-019-0245-7CrossRef
Metadaten
Titel
Assessing efficiency maternal and child health services in Morocco: data envelopement analysis and Tobit model
verfasst von
Youssef Er-Rays
Meriem M’dioud
Hamid Ait-Lemqeddem
Mustapha Ezzahiri
Publikationsdatum
29.05.2024
Verlag
Springer Netherlands
Erschienen in
Quality & Quantity / Ausgabe 6/2024
Print ISSN: 0033-5177
Elektronische ISSN: 1573-7845
DOI
https://doi.org/10.1007/s11135-024-01893-y