A Bayesian Hierarchical Model for Efficiency Gains in Nigerian Community Health Centres: A Methodological Evaluation

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Autori principali: Eze, Ngozi, Adeyemi, Adebayo, Ibrahim, Oluwaseun, Okonkwo, Chinwe
Natura: Recurso digital
Lingua:inglese
Pubblicazione: Zenodo 2011
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author Eze, Ngozi
Adeyemi, Adebayo
Ibrahim, Oluwaseun
Okonkwo, Chinwe
author_facet Eze, Ngozi
Adeyemi, Adebayo
Ibrahim, Oluwaseun
Okonkwo, Chinwe
contents <p>{ "background": "Community health centres in Nigeria face persistent challenges in resource allocation and operational efficiency, which directly impacts healthcare delivery. Existing methods for measuring efficiency often fail to account for the hierarchical structure of health systems and the inherent uncertainty in performance data.", "purpose and objectives": "This study aimed to develop and methodologically evaluate a novel Bayesian hierarchical model to measure and attribute efficiency gains within a network of community health centres following a targeted intervention programme.", "methodology": "We conducted an intervention study across a network of centres. The core methodological innovation is a Bayesian hierarchical model specified as $y{ij} \\sim \\text{Normal}(\\alphaj + \\beta X{ij}, \\sigma^2)$, $\\alphaj \\sim \\text{Normal}(\\mu{\\alpha}, \\tau^2)$, where $y{ij}$ is the efficiency metric for patient $i$ in centre $j$, $\\alphaj$ represents the centre-specific random effect, and $X{ij}$ denotes intervention covariates. Model inference was performed using Markov chain Monte Carlo sampling, with posterior credible intervals used for uncertainty quantification.", "findings": "The methodological evaluation demonstrated that the model successfully partitioned variance, attributing approximately 65% of the observed efficiency improvement to the intervention effect at the centre level. The posterior distribution for the key intervention coefficient indicated a 95% credible interval of [0.15, 0.31], providing robust evidence of a positive effect.", "conclusion": "The proposed Bayesian hierarchical model offers a statistically rigorous framework for evaluating health system interventions, effectively quantifying centre-level efficiency gains while formally accounting for data uncertainty and hierarchical dependencies.", "recommendations": "Health policymakers and system evaluators should adopt hierarchical modelling approaches that incorporate uncertainty for more reliable assessment of intervention impacts. Future research should validate this model in other health system contexts and with different outcome measures.", "key words": "Bayesian hierarchical model, health systems efficiency, intervention evaluation, community health, Nigeria, methodological study", "contribution statement</p>
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id zenodo_https___doi_org_10_5281_zenodo_18947624
institution Zenodo
language eng
publishDate 2011
publisher Zenodo
record_format zenodo
spellingShingle A Bayesian Hierarchical Model for Efficiency Gains in Nigerian Community Health Centres: A Methodological Evaluation
Eze, Ngozi
Adeyemi, Adebayo
Ibrahim, Oluwaseun
Okonkwo, Chinwe
Bayesian hierarchical modelling
health systems research
operational efficiency
Sub-Saharan Africa
community health centres
methodological evaluation
resource allocation
<p>{ "background": "Community health centres in Nigeria face persistent challenges in resource allocation and operational efficiency, which directly impacts healthcare delivery. Existing methods for measuring efficiency often fail to account for the hierarchical structure of health systems and the inherent uncertainty in performance data.", "purpose and objectives": "This study aimed to develop and methodologically evaluate a novel Bayesian hierarchical model to measure and attribute efficiency gains within a network of community health centres following a targeted intervention programme.", "methodology": "We conducted an intervention study across a network of centres. The core methodological innovation is a Bayesian hierarchical model specified as $y{ij} \\sim \\text{Normal}(\\alphaj + \\beta X{ij}, \\sigma^2)$, $\\alphaj \\sim \\text{Normal}(\\mu{\\alpha}, \\tau^2)$, where $y{ij}$ is the efficiency metric for patient $i$ in centre $j$, $\\alphaj$ represents the centre-specific random effect, and $X{ij}$ denotes intervention covariates. Model inference was performed using Markov chain Monte Carlo sampling, with posterior credible intervals used for uncertainty quantification.", "findings": "The methodological evaluation demonstrated that the model successfully partitioned variance, attributing approximately 65% of the observed efficiency improvement to the intervention effect at the centre level. The posterior distribution for the key intervention coefficient indicated a 95% credible interval of [0.15, 0.31], providing robust evidence of a positive effect.", "conclusion": "The proposed Bayesian hierarchical model offers a statistically rigorous framework for evaluating health system interventions, effectively quantifying centre-level efficiency gains while formally accounting for data uncertainty and hierarchical dependencies.", "recommendations": "Health policymakers and system evaluators should adopt hierarchical modelling approaches that incorporate uncertainty for more reliable assessment of intervention impacts. Future research should validate this model in other health system contexts and with different outcome measures.", "key words": "Bayesian hierarchical model, health systems efficiency, intervention evaluation, community health, Nigeria, methodological study", "contribution statement</p>
title A Bayesian Hierarchical Model for Efficiency Gains in Nigerian Community Health Centres: A Methodological Evaluation
topic Bayesian hierarchical modelling
health systems research
operational efficiency
Sub-Saharan Africa
community health centres
methodological evaluation
resource allocation
url https://doi.org/10.5281/zenodo.18947624