COUNCIL DESIGNATED HOSPITALS (CDHs) – VOLUNTEERING AGENCY HOSPITALS (VAHs): DOES IT MAKE A DIFFERENCE?: A COMPARATIVE ANALYSIS OF HOSPITALS’ PRODUCTIVITY IN TANZANIa

Kembo A Bwana

Abstract


Literature records that there are a few studies assessing hospitals ‘productivity in Tanzania. Council Designated Hospitals (CDHs) are private not for profit hospitals which operate as council or district referral hospitals; on the other hand Volunteering Agency Hospitals (VAHs) are private not for profit hospitals which do not have contract to operate as the council or district hospitals. This study attempts to shed light on the productivity comparison between VAHs and CDHs, with the sample size of 34 hospitals (17 CDHs and 17 VAHs), data were extracted from respective hospitals’ annual reports and collected using the stratified sampling procedure, in this case zones (lake, eastern, western, southern and northern zone) were treated as stratum from which data for VAHs and CDHs were drawn. The aim of using stratified sampling was to get representation of the total population (90 faith based private hospitals) in the country; the method is also suitable for the study which focuses on specific issues. The study employed Malmquist Productivity Index (MPI) model to examine productivity over the sampled period from 2012/13 to 2015/16. The study is significant since it tells the extent to which the productivity between CDHs and VAHs differ, as well as factors behind observed productivity change between the two categories. The study also suggests what should be done to improve productivity growth of the two categories. Result revealed that, the Total Factor Productivity (TFP) mean for the VAHs and CDHs were 1.101 and 0.994 respectively, implying VAHs category was experiencing progress in overall productivity meanwhile their counterpart CDHs was experiencing the regress in Total Factor Productivity (TFP). The total factor productivity of VAHs of 1.101 implies that on average over the sampled period, there is 10.1 per cent productivity progress. Improvements in VAHs’ TFP were largely due to the technological change rather than the efficiency change. On the other hand the productivity of CDHs of 0.994 implies that on average over the sampled period, there is 0.6 percent productivity regress. Deterioration in CDHs’ productivity was largely caused by regress in technological change rather than efficiency change. The study concludes that both components of overall productivity attributed to the change in Total Factor Productivity (TFP) of hospitals under the study. However, technological change seemed to be much influential in deriving the regress or progress of productivity of hospitals under the scrutiny. Since productivity is the ratio of the volume of output to the volume of inputs, the result implies that CDHs had been producing outputs less by 0.6 percent over the sampled period. The study recommends that CDHs should invest in new technology, new healthcare services, new management systems as well as new methodologies in order to improve technical change (innovation). On the other hand VAHs should improve knowledge diffusions so as to move towards the frontier (catch up effect).

Keywords


Council Designated Hospitals (CDHs), Volunteering Agency Hospitals (VAHs), Comparative analysis of Productivity, Tanzania

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