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首页> 外文期刊>Health policy and planning >Exploring SWAp's contribution to the efficient allocation and use of resources in the health sector in Zambia.
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Exploring SWAp's contribution to the efficient allocation and use of resources in the health sector in Zambia.

机译：探索SWAp对赞比亚卫生部门有效分配和使用资源的贡献。

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Zambia introduced a sector-wide approach (SWAp) in the health sector in 1993. The goal was to improve efficiency in the use of domestic funds and externally sourced development assistance by integrating these into a joint sectoral framework. Over a decade into its existence, however, the SWAp remains largely unevaluated. This study explores whether the envisaged improvements have been achieved by studying developments in administrative, technical and allocative efficiency in the Zambian health sector from 1990-2006. A case study was conducted using interviews and analysis of secondary data. Respondents represented a cross-section of stakeholders in the Zambian health sector. Secondary data from 1990-2006 were collected for six indicators related to administrative, technical and allocative efficiency. The results showed small improvements in administrative efficiency. Transaction costs still appeared to be high despite the introduction of the SWAp. Indicators for technical efficiency showed a drop in hospital bed utilization rates and government share of funding for drugs. As for allocative efficiency, budget execution did not improve with the SWAp, although there were large variations between both donors and year. Funding levels had apparently improved at district level but declined for hospitals. Finally, the SWAp had not succeeded in bringing all external assistance together under a common framework. Despite strong commitment to implement the SWAp in Zambia, the envisaged efficiency improvements do not seem to have been attained. Possible explanations could be that the SWAp has not been fully developed or that not all parties have completely embraced it. SWAp is not ruled out as a coordination model, but the current setup in Zambia has not proved to be fully effective.
机译：赞比亚于1993年在卫生部门采用了全行业方法。其目标是通过将国内资金和外部来源的发展援助纳入联合部门框架来提高其使用效率。但是，SWAp成立已有十多年了，在很大程度上尚未得到评估。本研究探讨了通过研究1990-2006年期间赞比亚卫生部门在行政，技术和分配效率方面的发展是否实现了预期的改进。使用访谈和辅助数据分析进行了案例研究。受访者代表了赞比亚卫生部门的利益相关者。 1990-2006年的二级数据收集了与行政，技术和分配效率有关的六个指标。结果显示，管理效率方面的改进很小。尽管引入了SWAp，交易成本似乎仍然很高。技术效率指标显示医院病床利用率下降和政府用于药物的资金份额下降。至于分配效率，尽管捐助者和年份之间存在很大差异，但预算执行并没有随着全部门做法的改善。筹资水平显然在地区级有所改善，但医院有所下降。最后，全部门办法未能在一个共同框架内将所有外部援助汇集在一起​​。尽管坚定地承诺在赞比亚实施全部门办法，但似乎并未实现预期的效率提高。可能的解释可能是SWAp尚未完全开发，或者并非所有各方都完全接受它。不排除将SWAp作为协调模型，但是赞比亚的当前设置尚未被证明是完全有效的。

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