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Assessing the efficiency of mother-to-child HIV prevention in low- and middle-income countries using data envelopment analysis

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Abstract

AIDS is one of the most significant health care problems worldwide. Due to the difficulty and costs involved in treating HIV, preventing infection is of paramount importance in controlling the AIDS epidemic. The main purpose of this paper is to explore the potential of using Data Envelopment Analysis (DEA) to establish international comparisons on the efficiency of implementation of HIV prevention programmes. To do this we use data from 52 low- and middle-income countries regarding the prevention of mother-to-child transmission of HIV. Our results indicate that there is a remarkable variation in the efficiency of prevention services across nations, suggesting that a better use of resources could lead to more and improved services, and ultimately, prevent the infection of thousands of children. These results also demonstrate the potential strategic role of DEA for the efficient and effective planning of scarce resources to fight the epidemic.

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Acknowledgement

The authors thank the anonymous reviewers for the insightful comments and helpful suggestions. We also would like to thank Graeme Doherty for useful comments during the preparation of this paper. Funding support for this research was provided by Fundação para a Ciência e a Tecnologia (FEDER/POCI2010).

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Authors and Affiliations

  1. Faculty of Economics, University of Algarve, 8005-139, Faro, Portugal

    Sérgio P. Santos & Carla A. E. Amado

  2. CEFAGE-UE, University of Évora, Évora, Portugal

    Sérgio P. Santos & Carla A. E. Amado

  3. CASEE, University of Algarve, Faro, Portugal

    Mauro F. Santos

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  1. Sérgio P. Santos
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Correspondence to Sérgio P. Santos.

Appendix

Appendix

Multiplier version of the DEA model used in the analysis (includes one weight restriction)

$$ \frac{1}{{{E_0}}} = Mi{n}{ }\sum\limits_{{i = 1}}^5 {{V_i}{X_{{i0}}} - {w_0}}; $$

Subject to:

$$ \begin{array}{*{20}{c}} {\sum\limits_{{r = 1}}^4 {{U_r}{Y_{{r0}}}} = 1} \hfill \\ {\begin{array}{*{20}{c}} {\sum\limits_{{r = 1}}^4 {{U_r}{Y_{{rj}}}} - \sum\limits_{{i = 1}}^5 {{V_i}{X_{{ij}}} + {w_0} \leqslant 0\quad z} } & {\left( {j = 1, \ldots, 52} \right)} \\ \end{array} } \hfill \\ {{V_1}{X_{{10}}} - \sum\limits_{{i = 2}}^5 {{V_i}{X_{{i0}}} \geqslant 0} } \hfill \\ \begin{gathered} {U_r};{V_i} \geqslant \varepsilon > 0 \hfill \\ \begin{array}{*{20}{c}} {{w_0}{ }free in sign} & {\left( {i = 1, \ldots, 5} \right);\left( {r = 1, \ldots, 4} \right)} \\ \end{array} \hfill \\ \end{gathered} \hfill \\ \end{array} $$

Where E 0 is the relative efficiency of DMU 0 , X i0 is the quantity of Input i used by DMU 0 (with i = 1 … 5) and Y r0 the quantity of Output r produced by DMU 0 (with r = 1, …, 4), V i is the weight attributed to Input i, U r is the weight attributed to Output r, and w 0 is the scale variable for DMU 0 .

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Santos, S.P., Amado, C.A.E. & Santos, M.F. Assessing the efficiency of mother-to-child HIV prevention in low- and middle-income countries using data envelopment analysis. Health Care Manag Sci 15, 206–222 (2012). https://doi.org/10.1007/s10729-012-9196-9

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