Health system productivity in sub-Saharan Africa: tuberculosis control in high burden countries.

IF 1.7 4区医学 Q3 HEALTH POLICY & SERVICES

Cost Effectiveness and Resource Allocation Pub Date : 2023-11-25 DOI:10.1186/s12962-023-00485-1

Esso-Hanam Atake

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Abstract

Background: Sixteen of the 30 countries with a high tuberculosis (TB) burden are in Sub-Saharan Africa (SSA). Over 25% of TB deaths occur in the Africa region. This study aims to estimate the productivity changes of TB programs in 16 SSA countries where TB is endemic.

Methods: We used Hicks-Moorsteen index to compute and decompose Total factor productivity (TFP), and the β-convergence and σ-convergence tests to check for convergence patterns among SSA countries.

Results: We found that technological change has been the main driver of the TFP growth, and that increasing technical efficiency may be the first objective in efforts to improve TFP of TB programs. Moreover, the convergence tests reveal significant homogeneity in terms of TFP change between SSA countries studied.

Conclusion: The findings suggest that improving technical efficiency of TB programs mainly calls for better resource allocation, capacity building in governance and management of programs, improved training of the health providers and stronger prevention policies. Policymakers must design models for integration of TB treatment under the universal health insurance schemes.

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撒哈拉以南非洲的卫生系统生产力:高负担国家的结核病控制。

背景:30个结核病高负担国家中有16个位于撒哈拉以南非洲(SSA)。25%以上的结核病死亡发生在非洲区域。本研究旨在估计结核病流行的16个撒哈拉以南非洲国家结核病规划的生产力变化。方法:采用Hicks-Moorsteen指数对全要素生产率(TFP)进行计算和分解，并通过β-收敛和σ-收敛检验检验SSA国家间的收敛模式。结果:我们发现，技术变革是TFP增长的主要驱动力，提高技术效率可能是提高结核病项目TFP的首要目标。此外，收敛检验表明，在研究的SSA国家之间，TFP变化具有显著的同质性。结论:研究结果表明，提高结核病规划的技术效率主要需要改善资源配置、规划治理和管理能力建设、改进卫生服务提供者培训和加强预防政策。决策者必须设计将结核病治疗纳入全民健康保险计划的模式。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cost Effectiveness and Resource Allocation HEALTH POLICY & SERVICES-

CiteScore

3.40

自引率

4.30%

发文量

审稿时长

34 weeks

期刊介绍： Cost Effectiveness and Resource Allocation is an Open Access, peer-reviewed, online journal that considers manuscripts on all aspects of cost-effectiveness analysis, including conceptual or methodological work, economic evaluations, and policy analysis related to resource allocation at a national or international level. Cost Effectiveness and Resource Allocation is aimed at health economists, health services researchers, and policy-makers with an interest in enhancing the flow and transfer of knowledge relating to efficiency in the health sector. Manuscripts are encouraged from researchers based in low- and middle-income countries, with a view to increasing the international economic evidence base for health.