A Performance Review of Sexual and Reproductive Health Centers in Sierra Leone: A Data Envelopment Analysis Approach

How is success measured in the field of health care, particularly for nonprofit or nongovernmental organizations dedicated to provide help to underprivileged patients? Who determines if extra dollars of preventive care are worth more or less than an invented pharmaceutical drug? How can the health care industry compare hospital recovery and rehabilitation rates? Such questions are difficult to answer, because healthcare institutions lack a uniform definition of success, which usually encompasses tangible factors, such as number of patients served, number of medical patents obtained, number of surgeries performed, and patient-to-cost ratios. Certain health care organizations look at less tangible factors, such as an ability to provide outstanding treatment, overall medical research reputation, and the impact of their inventions/procedures in the market. Given such a wide diversity of success indicators and given the fact those health care providers often pursue particular aspects of ¡§health¡¨ outcomes; a valid and reliable performance comparison of provider success can be difficult. This research looks at and maps out the nature and characteristics of a nongovernmental institution that provides sexual and reproductive healthcare services in the West African nation of Sierra Leone. The problems associated with measuring the performance of such an institution mirror the issues mentioned above. This researcher decided to use the non-stochastic frontier model of Data Envelopment Analysis (DEA) to solve some of these issues. DEA, commonly used in Operations Research literature to evaluate the efficiency of multiple producers, can, under certain assumptions, define a locus of technically-efficient points that could be estimated where multiple inputs and outputs and market prices are absent.