Health facility capacity and technical efficiency in the provision of adolescent sexual and reproductive health services in Niger.

backgroundEfficiency in the use of financial and other resources for providing adolescent sexual and reproductive health (ASRH) policies and programs is an important factor that can affect provision of and access to services in resource-constrained contexts of developing countries with limited capacity. However, very few studies have been conducted to understand this situation. Our study, therefore, estimated technical efficiency scores for health facilities that offer primary ASRH care services in Niger and the relationship between the capacity of these health facilities and their level of technical efficiency.

methodsThe data used for this study were collected from a survey of 71 primary healthcare facilities providing ASRH in Niger from January 28 to March 15, 2022. A stochastic frontier analysis technique based on the Cobb-Douglas production function specification was used for analysis. A Tobit model estimation was used to examine the relationship between health facility capacity and the level of technical efficiency.

resultsThe average technical efficiency in production of primary care ASRH services of the health facilities in the sample was 58% implying high levels of technical inefficiency. Disaggregated analysis revealed that the average score was greater in health facilities where the primary caretaker or head of the institution was female (60%) rather than male (53%). Primary healthcare facility capacity was assessed in four dimensions of operational capacity, managerial capacity, adaptive capacity and leadership capacity. There was a positive association between health facility capacity and the technical efficiency score. However, the levels of association differed from one dimension of health facility capacity to another.

conclusionsThere is much room for improving the efficient use of financial and other resources in primary healthcare facilities that provide ASRH in Niger. Potential interventions include giving women more responsibility for these facilities and strengthening the ASRH production capacity of these facilities.