In an effort to improve maternal, neonatal, and child health outcomes essential for meeting the Sustainable Development Goal (SDG) 2030 targets, Moroccan public hospitals are facing significant challenges. This study delves into the operational effectiveness of 76 Maternal, Neonatal, and Child Services Networks (MNCSN) across these hospitals, aiming to uncover the inefficiencies and propose solutions for better resource allocation and reduced mortality rates.
Efficiency Analysis Using DEA
The study employed Data Envelopment Analysis (DEA) to gauge the technical efficiency (TE) of the networks. Two orientations were used: Variable Returns to Scale for inputs (VRS-I) and outputs (VRS-O). The findings revealed a stark contrast between the two; VRS-I demonstrated a higher average TE score of 0.76, whereas VRS-O lagged significantly with a score of 0.23. Casablanca-Anfa MNCSN emerged as a top performer under VRS-I, receiving 30 referrals, while Khemisset followed with 24. Conversely, under VRS-O, Ben Msick, Rabat, and Mediouna MNCSNs had the highest references.
Factors Influencing Inefficiency
The Tobit method (TM) was utilized to identify factors contributing to inefficiency. Inputs considered included hospital infrastructure, doctor availability, and paramedical staff, while outputs involved admissions, cesarean interventions, functional capacity, and hospitalization days. The results indicated that doctors and functional bed capacity were the most significant factors, both scoring 0.01 on the Tobit model, followed by hospitalization days and cesarean sections.
Market access to quality healthcare services is crucial for enhancing the operational efficiency of MNCSNs. The study underscores the need for better resource allocation to improve market accessibility and ensure healthcare equity. The average Malmquist Index further highlighted a 7.7% productivity increase under VRS-I over nine years, contrasting with an 8.7% decline under VRS-O.
Key Inferences
Strategic Insights for Policymakers
- Technical efficiency can be significantly improved by prioritizing input factors such as doctors and functional bed capacity.
- Market access improvements can lead to better healthcare outcomes, evidenced by varying efficiency scores between VRS-I and VRS-O.
- Productivity trends suggest that focusing on input-oriented strategies could yield long-term benefits.
- Referral patterns indicate the need for systemic adjustments in resource distribution.
This study provides a comprehensive analysis of operational effectiveness within Moroccan public hospitals’ MNCSNs. It offers valuable insights for policymakers to optimize resource allocation and enhance the market access of maternal, neonatal, and child health services. Addressing these inefficiencies is paramount for achieving the health-related objectives of SDG 2030.
Original Article:
Eval Rev. 2024 Jul 20:193841X241264863. doi: 10.1177/0193841X241264863. Online ahead of print.
ABSTRACT
Maternal, neonatal, and child health play crucial roles in achieving the objectives of Sustainable Development Goal (SDG) 2030, particularly in promoting health and wellbeing. However, maternal, neonatal, and child services in Moroccan public hospitals face challenges, particularly concerning mortality rates and inefficient resource allocation, which hinder optimal outcomes. This study aimed to evaluate the operational effectiveness of 76 neonatal and child health services networks (MNCSN) within Moroccan public hospitals. Using Data Envelopment Analysis (DEA), we assessed technical efficiency (TE) employing both Variable Returns to Scale for inputs (VRS-I) and outputs (VRS-O) orientation. Additionally, the Tobit method (TM) was utilized to explore factors influencing inefficiency, with hospital, doctor, and paramedical staff considered as inputs, and admissions, cesarean interventions, functional capacity, and hospitalization days as outputs. Our findings revealed that VRS-I exhibited a higher average TE score of 0.76 compared to VRS-O (0.23). Notably, the Casablanca-Anfa MNCSN received the highest referrals (30) under VRS-I, followed by the Khemisset MNCSN (24). In contrast, under VRS-O, Ben Msick, Rabat, and Mediouna MNCSN each had three peers, with 71, 22, and 17 references, respectively. Moreover, the average Malmquist Index under VRS-I indicated a 7.7% increase in productivity over the 9-year study period, while under VRS-O, the average Malmquist Index decreased by 8.7%. Furthermore, doctors and functional bed capacity received the highest Tobit model score of 0.01, followed by hospitalization days and cesarean sections. This study underscores the imperative for policymakers to strategically prioritize input factors to enhance efficiency and ensure optimal maternal, neonatal, and child healthcare outcomes.
PMID:39032171 | DOI:10.1177/0193841X241264863
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