ArticleCost effectiveness and resource allocation : C/E2022
Efficiency analysis of primary healthcare facilities in Afghanistan.
Article in Cost effectiveness and resource allocation : C/E, 2022. 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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Who cites it
9 citing papers in PubMed, 11 citations in OpenAlex.
- Technical efficiency analysis of the Basic Health Care Provision Fund for the funded primary health care facilities in Nigeria.BMC primary care · 2026Article
- Technical efficiency of sub-district level hospitals in Bangladesh: a comparative frontier analysis.Health economics review · 2026Article
- The effects of a 13-year war on the reality of ophthalmology services and education in Syria.AJO international · 2025Article
- Health systems performance in health outcomes, health financing and COVID-19 pandemic: Lessons from 31 countries.PloS one · 2025Article
- Technical efficiency and its determinants in health service delivery of public health centers in East Wollega Zone, Oromia Regional State, Ethiopia: Two-stage data envelope analysis.BMC health services research · 2024Article
- Evaluating China's primary healthcare services' efficiency and spatial correlation: a three-stage DEA-Malmquist model.Frontiers in public health · 2024Article
- Predictors of antenatal care services utilization by pregnant women in Afghanistan: Evidence from the Afghanistan Health Survey 2018.PloS one · 2024Article
- Infectious diseases in Afghanistan: Strategies for health system improvement.Health science reports · 2023Article
- Overview and understanding of mental health and psychosocial support in Afghanistan.International health · 2023Article
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Authors and funding
7 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAfghanistan's health system is unique in that primary healthcare is delivered by non-governmental organizations funded by multilateral or bilateral donors, not the government. Given the wide range of implementers providing the basic package of health services, there may be performance differences in service delivery. This study assessed the relative technical efficiency of different levels of primary healthcare services and explored its determinants.
methodData envelopment analysis was used to assess the relative technical efficiency of three levels of primary healthcare facilities (comprehensive, basic, and sub-health centers). The inputs included personnel and capital expenditure, while the outputs were measured by the number of facility visits. Data on inputs and outputs were obtained from national health information databases for 1263 healthcare facilities in 31 provinces. Bivariate analysis was conducted to assess the correlation of various elements with efficiency scores. Regression models were used to identify potential factors associated with efficiency scores at the health facility level.
resultsThe average efficiency score of health facilities was 0.74 when pooling all 1,263 health facilities, with 102 health facilities (8.1%) having efficiency scores of 1 (100% efficient). The lowest quintile of health facilities had an average efficiency score of 0.36, while the highest quintile had a score of 0.96. On average, efficiency scores of comprehensive health centers were higher than basic and sub-health centers by 0.11 and .07, respectively. In addition, the difference between efficiency scores of facilities in the highest and lowest quintiles was highest in facilities that offer fewer services. Thus, they have the largest room for improvement.
conclusionsOur findings show that public health facilities in Afghanistan that provide more comprehensive primary health services use their resources more efficiently and that smaller facilities have more room for improvement. A more integrated delivery model would help improve the efficiency of providing primary healthcare in Afghanistan.
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