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Evaluating a maternal and child health capacity-building program in Senegal: environment-adjusted district efficiency
Sunjoo Kang1, Jinhyun Kim2,3, Heejin Kimm4,5
1Graduate School of Public Health, Yonsei University, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea. ksj5139@yuhs.ac.
BMC Health Services Research
|July 2, 2026
Summary
Capacity-building programs significantly improved maternal and child health efficiency in Senegal. Environment-adjusted scores showed intervention districts achieved full efficiency, closing gaps effectively.
Area of Science:
- Health Services Research
- Public Health
- Health Economics
Background:
- Low- and middle-income countries face challenges in district-level health service efficiency and equity, especially with international aid.
- Senegal utilizes the DHIS2 platform for monitoring maternal and child health (MCH) indicators.
- The impact of capacity-building programs on district efficiency, considering contextual factors and inefficiencies, is not well understood.
Purpose of the Study:
- To evaluate the effect of a capacity-building program on MCH service efficiency in central Senegal.
- To assess efficiency changes and identify gaps after accounting for environmental factors.
- To compare efficiency trends between intervention and comparison health districts.
Main Methods:
- Analysis of 2019 and 2023 data from 27 health districts in central Senegal.
- Technical efficiency (TE) estimated using input-oriented data envelopment analysis (DEA).
- Environmental factors (e.g., population demographics, facility distribution) incorporated for adjusted TE scores; gap reduction metrics calculated.
Main Results:
- Mean unadjusted TE was stable around 0.798 in 2019 and 0.796 in 2023.
- Intervention districts showed improved TE (0.840 to 0.916), while comparison districts declined (0.790 to 0.776).
- Fertility was a significant factor; environment-adjusted TE reached 1.000 in intervention districts and 0.901 in comparison districts by 2023, with substantial gap closure in intervention areas.
Conclusions:
- The MCH capacity-building program effectively reduced residual inefficiency in intervention districts.
- Environment-adjusted efficiency scores and gap reduction metrics provide valuable insights for program evaluation.
- Integrating demand-related factors and gap analysis supports equitable health program assessments in resource-limited settings.
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