ArticleHealth policy and planning2016
A comparison of hierarchical cluster analysis and league table rankings as methods for analysis and presentation of district health system performance data in Uganda.
Article in Health policy and planning, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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9 citing papers in PubMed.
- Article
- Transitioning health workers from PEPFAR contracts to the Uganda government payroll.Health policy and planning · 2021Article
- Dispensing antiretrovirals during Covid-19 lockdown: re-discovering community-based ART delivery models in Uganda.BMC health services research · 2021Article
- QALY league table of Iran: a practical method for better resource allocation.Cost effectiveness and resource allocation : C/E · 2021Review
- A critique of the Uganda district league table using a normative health system performance assessment framework.BMC health services research · 2018Article
- Using health-facility data to assess subnational coverage of maternal and child health indicators, Kenya.Bulletin of the World Health Organization · 2017Article
- Beyond pilotitis: taking digital health interventions to the national level in China and Uganda.Globalization and health · 2017Review
- Post-operative opioid pain management patterns for patients who receive hip surgery.Substance abuse treatment, prevention, and policy · 2017Observational
- Enablers and barriers to evidence based planning in the district health system in Uganda; perceptions of district health managers.BMC health services research · 2017Article
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6 authors.
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Abstract
In 2003, the Uganda Ministry of Health introduced the district league table for district health system performance assessment. The league table presents district performance against a number of input, process and output indicators and a composite index to rank districts. This study explores the use of hierarchical cluster analysis for analysing and presenting district health systems performance data and compares this approach with the use of the league table in Uganda. Ministry of Health and district plans and reports, and published documents were used to provide information on the development and utilization of the Uganda district league table. Quantitative data were accessed from the Ministry of Health databases. Statistical analysis using SPSS version 20 and hierarchical cluster analysis, utilizing Wards' method was used. The hierarchical cluster analysis was conducted on the basis of seven clusters determined for each year from 2003 to 2010, ranging from a cluster of good through moderate-to-poor performers. The characteristics and membership of clusters varied from year to year and were determined by the identity and magnitude of performance of the individual variables. Criticisms of the league table include: perceived unfairness, as it did not take into consideration district peculiarities; and being oversummarized and not adequately informative. Clustering organizes the many data points into clusters of similar entities according to an agreed set of indicators and can provide the beginning point for identifying factors behind the observed performance of districts. Although league table ranking emphasize summation and external control, clustering has the potential to encourage a formative, learning approach. More research is required to shed more light on factors behind observed performance of the different clusters. Other countries especially low-income countries that share many similarities with Uganda can learn from these experiences.
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