Technical Efficiency of Maternal and Child Health Program at Public Health Center in Indonesia

Abstract

The limited availability of health resources in the high public demand requires the health programs and service providers, especially in Public Health Center (Puskesmas) to make efficiency. This study aims to provide information about the level of technical efficiency of Puskesmas in Indonesia in organizing the Maternal and Child Health (MCH) program. This study also tries to investigate several factors that contribute to the level of Puskesmas efficiency in organizing MCH programs. This study was quantitative research with cross-sectional approach. This study used secondary data derived from Health Financing Research (Health Financing Research: RPK) in 2015 for Puskesmas level. The data analyzed by the non-parametric technique using DEAP software version 2.1 to obtain technical efficiency score of each Puskesmas. After getting the technical efficiency score, the researchers conducted multivariate analysis using Tobit Regression, with the dependent variable was technical efficiency score of MCH program and predictors were the category of public health development index, fiscal capacity index, financial management authority status (BLUD status), geographical status, and region category. The technical efficiency of the MCH program at Puskesmas level was 0.81 ±0.12. The efficiency scores were affected by geographic areas-where urban Puskesmas were more efficient than rural and remote areas-and regional fiscal capacity-where Puskesmas in areas with high fiscal capacity were more efficient than Puskesmas in areas with medium and low fiscal capacity. Areas with geographic limitations require more considerable health resources to obtain the same output than areas with more comfortable geographic conditions. Keywords—technical efficiency, data envelopment analysis, input-output