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A comparison of hierarchical cluster analysis and league table rankings as methods for analysis and presentation of district health system performance data in Uganda

Bibliographic Data

ID11490453
AuthorsChristine Kirunga Tashobya (Ministry of Health, corresponding author), Dominique Dubourg (0000-0002-8692-783X, Instituut voor Tropische Geneeskunde), Freddie Ssengooba (0000-0003-3489-0745, Makerere University), Niko Speybroeck (0000-0003-3322-3502, UCLouvain), Jean Macq (0000-0003-2905-2683, UCLouvain), Bart Criel (0000-0002-1452-0088, Instituut voor Tropische Geneeskunde)
Year2016
Volume31
Issue2
Pages217-228
Publication date2016-03-01
Open AccessYes
TypeARTICLE
VenueHealth Policy and Planning (JOURNAL)
Journal identifiersISSN: 0268-1080 • E-ISSN: 1460-2237
PublisherOxford University Press (PUBLISHER • GB)
DOI10.1093/heapol/czv045
PMID26024882
OpenAlexW2261717200
LanguageEN
Citations received2
References cited31

In 2003, the Uganda Ministry of Health introduced the district league table for district health system performance assessment. The league table presents district performance against a number of input, process and output indicators and a composite index to rank districts. This study explores the use of hierarchical cluster analysis for analysing and presenting district health systems performance data and compares this approach with the use of the league table in Uganda. Ministry of Health and district plans and reports, and published documents were used to provide information on the development and utilization of the Uganda district league table. Quantitative data were accessed from the Ministry of Health databases. Statistical analysis using SPSS version 20 and hierarchical cluster analysis, utilizing Wards' method was used. The hierarchical cluster analysis was conducted on the basis of seven clusters determined for each year from 2003 to 2010, ranging from a cluster of good through moderate-to-poor performers. The characteristics and membership of clusters varied from year to year and were determined by the identity and magnitude of performance of the individual variables. Criticisms of the league table include: perceived unfairness, as it did not take into consideration district peculiarities; and being oversummarized and not adequately informative. Clustering organizes the many data points into clusters of similar entities according to an agreed set of indicators and can provide the beginning point for identifying factors behind the observed performance of districts. Although league table ranking emphasize summation and external control, clustering has the potential to encourage a formative, learning approach. More research is required to shed more light on factors behind observed performance of the different clusters. Other countries especially low-income countries that share many similarities with Uganda can learn from these experiences.

Cluster (spacecraft) · Cluster analysis · Data mining · Economics · Hierarchical clustering · Information retrieval · League table · Ranking (information retrieval) · Table (database) · Artificial Intelligence · Computer Science · Global Maternal and Child Health · Healthcare Systems and Reforms

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Citations per year0.22
Citation span2017 - 2018 (2)
Highly citedNo

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