Kirigia, J. M., Z. Asbu, et al. (2007). “Technical Efficiency, Efficiency Change, Technical Progress and Productivity Growth in the National Health Systems of Continental African Countries.” Eastern Africa Social Science Research Review 32(2): 12 p.

Background: In May 2006, the Ministers of Health of all the countries in the African continent, at a special session of the African Union, undertook to institutionalise efficiency monitoring within the national health information management systems. The specific objectives of this study were: (i) to assess the technical efficiency of National Health Systems (NHSs) of African continent countries for producing male and female life expectancies; and (ii) to assess changes in health productivity over time with a view to analysing changes in efficiency and changes in technology., Methods: The analysis was based on a five-year panel data (1999-2003) from all the 53 African continent countries. Data Envelopment Analysis (DEA), a non-parametric linear programming approach, was employed to assess the technical efficiency. Malmquist Total Factor Productivity (MTFP) was used to analyse efficiency and productivity change over time among the 53 countries? national health systems (NHS). The data consisted of two outputs (male and female life expectancies) and two inputs (per capital total health expenditure and adult literacy., Results: The DEA has revealed that 49 (92.5%) countries NHSs were run inefficiently in 1999 and 2000; 50 (94.3%) were operated inefficiently in 2001; 48 (90.6%) were run inefficiently in 2002; and 47 (88.7%) were operated inefficiently during 2003. All the 53 countries? national health systems registered improvements in total factor productivity attributable mainly to technical progress. Fifty-two countries did not experience any change in scale efficiency. Thirty (56.6%) countries? national health systems had a PEFFCH index of less than one, signifying that those countries? NHSs pure efficiency contributed negatively to productivity change., Conclusion: All the 53 countries? national health systems registered improvements in total factor productivity attributable mainly to technical progress. Over half of the countries? national health systems had a pure efficiency index of less than one, signifying that those countries? NHSs pure efficiency contributed negatively to productivity change. African countries may need to critically evaluate the utility of institutionalising of the Malmquist TFP type of analyses to monitor the changes in health systems economic efficiency and productivity over time.