The determinants of technical efficiency of a large scale HIV prevention project: application of the DEA double
Aurélia Lépine1, Anna Vassall1, Sudhashree Chandrashekar2
1Social 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.
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.
Related Concept Videos
Statistical Methods for Analyzing Epidemiological Data
Bootstrapping
Study Designs in Epidemiology
Observational studies are those where the researcher does not intervene but rather observes natural variations. They include cross-sectional, cohort, and...
Hazard Ratio
For example, in a clinical trial...
Bias in Epidemiological Studies
Production Efficiency


