Health Systems' Efficiency

The EFFSIG endeavours not only to share best policy practices and governance processes of different health systems but also remains committed to the advancement of methodologies for examining health systems’ performance. Thus, our discourse addresses important policy issues for global development process involving different health systems.

Quantifying multidimensional goals of the national health system is always a challenge. EFFSIG catalyses harnessing of expertise and forging of partnerships within and beyond iHEA and that generates actionable insights for balancing the apparent trade-offs between health equity and health system’s efficiency with sufficiency in the provisioning of the healthcare services given the available resources.

A membership in the Health Systems’ Efficiency’ Special Interest Group is an opportunity to consolidate learning with systems thinking for becoming more impactful and efficient at designing and developing the health systems within different national realities and capacities.


Resilience and Efficiency: How we understand?


For realising the objectives, our start-up activities include:

  1. hosting online webinars (3 times in a year) on the theme for the scientific community and professionals;
  2. organizing virtual visits with the members of SIG who validate model with country specific data from a range of different contexts;
  3. uploading international databases for research on measuring health system’s efficiency – within and between countries ;
  4. creating metadata and harmonising datasets for replicating analysis in different country contexts;
  5. presenting a short summary (from high standing academic literature) on the theme at a definite interval to iHEA newsletter;
  6. organising regular scientific discourse on methodological applications and on alignment of health systems’ performance with SDG achievements (Goal 3.8) in partnership with country specific higher education institution for development of the local expertise.

Further, we are developing a digital repository of case studies on the theme.

We also offer our expertise to early career researcher (s) for pre-submission review of scientific article (s) on the theme, and organise (1) pre-congress session and / or (2) training workshops on the theme at the biennial IHEA congress.


  • Improvising on Evolution: Revised Guidelines for Efficiency Measurement in Health and Health Care – December 5, 2023
  • Estimation of Regression Discontinuity and Kink Designs with Multiple Running Variables – A Design Having Potential for Health System Research – November 2, 2023
  • A Blended Model of Provider Payment Mechanism for an Efficient Health System: An Experience From Sudan for Improving Health Outcomes in LMICs – May 27, 2022
  • Efficiency Measures of Health Systems and Universal Health Coverage (UHC) in Ghana – March 18, 2022
  • Efficiency contributions of drug procurement mechanisms to the health systems of LMICs – December 9, 2021
  • A novel approach to estimating healthcare delivery system value – 50 states of USA between 1991-2019 – December 16, 2021
  • Health technology assessment for evidence-based decision-making in a Regional Hospital of Singapore – October 29, 2021
  • Validation of Value of Statistical Life as an Output Measure for Health System’s Efficiency – March 26, 2021
  • Understanding the performance of hospitals in Chile using Data Envelopment Analysis (DEA) – November 27, 2020
  • Assessing technical efficiency of health systems and programs: A discussion of traditional and new approaches – April 24, 2020
  • Assessing country UHC performance relative to spending: A DEA investigation – November 29, 2019
  • Another take on the efficiency question? Wasteful spending on health – insights from OECD countries – September 27, 2019
  • Health Systems performance: how to measure it and why? – March 29, 2019

The members of “Health Systems’ Efficiency’ Special Interest Group (EFFSIG)” of IHEA in collaborations with the country specific researchers is acquiring subnational level data from the public domains of countries across different geographies of the World.

The metadata comprises:

(1) size of the population distributed by gender for different age-groups;
(2) distribution of population by the settlement of residence (urban and rural);
(3) population density;
(4) age-specific life expectancy;
(5) age-group specific disability prevalence;
(6) incidence (number of new admissions in the year) of circulatory disease, respiratory disease, heart disease, kidney disease, liver disease, diseases of digestive system, musculoskeletal disorder, neurological problems, endocrine problems and infectious diseases (excluding tuberculosis) for different age groups distributed by gender;
(7) mortality from circulatory disease, respiratory disease, heart disease, kidney disease, liver disease, diseases of  digestive system, musculoskeletal disorder, neurological problems, endocrine problems and infectious diseases (excluding tuberculosis) for different age groups distributed by gender;
(8) number of emergency episodes;
(9) costs of the health systems; and
(10) per capita income.

These data can be used by anyone having a valid IHEA membership for academic and policy research subscribing to the objectives of EFFSIG.

EFFSIG – IHEA fosters research, in particular, that:

(1) unfolds subnational differences in the performance of the country specific health systems impacting equity in outcome,
(2) highlights diverse insights into methodological framework for science to policy and action given the characteristics of the health system, and
(3) examines normative implications in the organisation of the health system within the national priorities and the policy space.  

All publications (including working papers and dissertation theses) must acknowledge the efforts of EFFSIG – iHEA besides capturing the data source (s) specified for each country. Any such publication is to be sent to  by the author (s) for summary dissemination to the members of iHEA, and also, for initiating discussion towards professional contributions to the development of the specialty and to the public policy development.


Convenor: Dr. Pavitra Paul
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Co-Convenor: Kathy Tannous
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Co-Convenor: Mery Bolivar
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Co-Convenor: Jacob Novignon
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