The determinants of technical efficiency of a large scale HIV prevention project: application of the DEA double bootstrap using panel data from the Indian Avahan

Cost Effectiveness and Resource Allocation

Sudhashree Chandrashekar¹  Anna Vassall²  Aurélia Lépine² 

[1] St. John’s Research Institute, Department of Epidemiology and Biostatistics, St. John Nagar, Bangalore 560034, India;Social and Mathematical Epidemiology (SAME) Group, Department of Global Health and Development, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, UK

关键词: India;    Double bootstrapping;    Two-stage DEA;    Scale-up;    HIV prevention;   

Others  :  1160676
DOI  :  10.1186/s12962-015-0031-2

 received in 2014-10-21, accepted in 2015-02-10,  发布年份 2015

【 摘 要 】

Background

In 2004, the largest HIV prevention project (Avahan) conducted globally was implemented in India. Avahan was implemented by NGOs supported by state lead partners in order to provide HIV prevention services to high-risk population groups. In 2007, most of the NGOs reached full coverage.

Methods

Using a panel data set of the NGOs that implemented Avahan, we investigate the level of technical efficiency as well as the drivers of technical inefficiency by using the double bootstrap procedure developed by Simar & Wilson (2007). Unlike the two-stage traditional method, this method allows valid inference in the presence of measurement error and serial correlation.

Results

We find that over the 4 years, Avahan NGOs could have reduced the level of inputs by 43% given the level of outputs reached. We find that efficiency of the project has increased over time. Results indicate that main drivers of inefficiency come from the characteristics of the state lead partner, the NGOs and the catchment area.

Conclusion

These organisational factors are important to explicitly consider and assess when designing and implementing HIV prevention programmes and in setting benchmarks in order to optimise the use and allocation of resources.

JEL classifications

C14, I1

【 授权许可】

   
2015 Lepine et al.; licensee BioMed Central.

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