Measuring Technical Efficiency of CEmONC Centers of Tamil Nadu using Stochastic Frontier Analysis

Abstract

Background: In order to promote safe motherhood,several Comprehensive Emergency Obstetric and Newborn Care (CEmONC) centers have been setup all over Tamil Nadu under the World-bank funded Tamil Nadu Health Systems Project (TNHSP) in2005. Objective: To estimate technical efficiency of CEmONC centers (n=46) in Tamil Nadu over eight years period (2006-07 to 2013-14). Data and Method: The technical inefficiency of the CEmONC has been estimated using aparametric approach --- Stochastic Frontier Analysis (SFA). The production function of live births is expressed as a function of physical input (beds), and human capital inputs (doctors and nurses). Results: The results from Greene‘s True Fixed Effects and True Random Effects Models are similar after accounting for time varying heterogeneity in the technical inefficiency term. Thus, either model confirms the fact that unobserved heterogeneity is not correlated with the explanatory variables.The preliminary results suggest that the average inefficiency level is around 12% across the 47 CEmONC centers. The inefficiency levels first decrease and then increase with an increase in doctors and nurses keeping the number of beds constant. Limitations: The study relies on single output- live births- carries the risk that important information on other dimensions of performance, such as interpersonal aspects or timeliness of care, may not be revealed.