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Ethiopia’s PBF in healthcare: An assessment of efficiency and productivity - P4H Network

Ethiopia’s PBF in healthcare: An assessment of efficiency and productivity

The Ethiopian government’s recent healthcare financing reform, which piloted performance-based financing (PBF) in health facilities, aimed to improve efficiency. However, new research reveals that PBF has not achieved the expected productivity gains.
Key Findings:

  • Technical Efficiency: PBF facilities had a mean technical efficiency score of 64%, suggesting a potential 36% input reduction without affecting outputs. Non-PBF facilities scored 62%.
  • Scale Efficiency: PBF facilities showed an 88% scale efficiency, indicating a potential 12% output increase without expansion. Non-PBF facilities had an 87% scale efficiency.
  • Productivity: PBF facilities experienced a 1.3% decrease in mean total productivity over three years, while non-PBF facilities remained stagnant.

Conclusion:

The study concludes that PBF did not improve productivity in Ethiopian healthcare facilities, with those implementing PBF utilizing more resources for similar outputs. This finding calls for a reassessment of PBF strategies to ensure they enhance healthcare delivery effectively.

 

Reference
Mideksa Adugna, Girmaye Dinsa & Nelisiwe Khuzwayo , Can performance-based financing improve efficiency of health centers in Ethiopia? A Malmquist Productivity Index analysis, BMC Health Services Research
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