Publications

Journal Article

Motivated by the cost reductions and outcome improvements generated by benchmarking in many industries, the authors focus on in-country global health programs to identify and quantify opportunities for process improvement.

The authors empirically study the major efficiency drivers of reproductive health (RH) country programs in Sub-Saharan Africa sponsored by international funding organizations. To ensure a level playing field for comparison across countries, the authors quantify the impact of cross-country heterogeneity and random shocks on the efficiency of RH programs.

To analyze these relationships and isolate the effects attributable to managerial inefficiency, the authors use a three-stage Data Envelopment Analysis (DEA)/Stochastic Frontier Analysis (SFA) model. The authors show the impact of environmental factors on program efficiency, linking policy making decisions with operational and health outcome performance.

The authors also show that donor fragmentation negatively impacts managerial efficiency, and they suggest actions to mitigate this effect.

The authors then provide a way to improve performance through benchmarking efforts within groups of countries and present an initial prototype of such efforts.