Abstract

Gurinder David Loroupe

From 60% in 1990, attendance at public hospitals in Togo has declined significantly and is estimated at 30.08% in 2010. Less than half of child deliveries took place in these hospitals. From 2008 to 2012, it was noted that there was an average increase of patient deaths by 10%. This study aims at analyzing the sources of productivity changes in Togo public hospitals. The Hicks-Moorsteen’s productivity index was used to analyze the productivity changes of 139 public hospitals over a period of four years (2008-2011). On average, productivity has declined significantly over the study period. This decrease is explained by the level of efficiency of large hospitals. The low level of efficiency of large hospitals is mainly due to a deficiency in the maintenance of medical equipment, aging biomedical equipment, lack of physicians, and inadequate infrastructure. Improving technical efficiency observed was found to be insufficient to increase productivity. The results suggest that the increase of technical efficiency has not yet reached the threshold required to trigger growth in productivity. Increasing technical efficiency would be the first goal to be set for improving public hospitals productivity. It should, also, encourage new investment that would improve production technology.