Achoki Tom, Kinfu Yohannes, Masiye Felix, Frederix Geert W J, Hovels Anke, Leufkens Hubert G
Department of Global Health, Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
Centre for Pharmaceutical Policy and Regulation, Utrecht University, Utrecht, The Netherlands.
J Public Health Policy. 2017 Feb;38(1):88-104. doi: 10.1057/s41271-016-0046-8.
Efficiency and productivity improvement have become central in global health debates. In this study, we explored productivity change, particularly the contribution of technological progress and efficiency gains associated with improvements in child survival in Zambia (population 15 million). Productivity was measured by applying the Malmquist productivity index on district-level panel data. The effect of socioeconomic factors was further analyzed by applying an ordinary least squares regression technique. During 2004-2009, overall productivity in Zambia increased by 5.0 per cent, a change largely attributed to technological progress rather than efficiency gains. Within-country productivity comparisons revealed wide heterogeneity in favor of more urbanized and densely populated districts. Improved cooking methods, improved sanitation, and better educated populations tended to improve productive gains, whereas larger household size had an adverse effect. Addressing such district-level factors and ensuring efficient delivery and optimal application of existing health technologies offer a practical pathway for further improving population health.
提高效率和生产力已成为全球卫生辩论的核心议题。在本研究中，我们探讨了生产力变化，特别是与赞比亚（人口1500万）儿童存活率提高相关的技术进步和效率提升的贡献。通过对地区层面的面板数据应用Malmquist生产力指数来衡量生产力。运用普通最小二乘法回归技术进一步分析社会经济因素的影响。在2004年至2009年期间，赞比亚的总体生产力提高了5.0%，这一变化主要归因于技术进步而非效率提升。国内生产力比较显示出有利于城市化程度更高和人口更密集地区的广泛异质性。改进烹饪方法、改善卫生条件和人口受教育程度提高往往会促进生产收益，而家庭规模较大则有不利影响。解决此类地区层面的因素，并确保现有卫生技术的有效提供和最佳应用，为进一步改善人口健康提供了一条切实可行的途径。
