Critique Of The Concept Of Efficiency In Public Health Management: A Qualitative Review Of Social Justice-Based Health Policy

Introduction: the concept of efficiency in public health management is increasingly central to global health policy. However, it often creates tension with social justice, particularly in contexts where cost-effectiveness takes precedence over equitable access to care. This research highlights the importance of examining how efficiency-driven health policies may unintentionally exacerbate social inequalities. Methods: this study uses a qualitative literature review to analyze 35 peer-reviewed articles, policy documents, and global health reports published between 2010 and 2024. Thematic analysis was employed to identify patterns and tensions between efficiency goals and social justice principles in public health policy. findings: (1) Efficiency-focused policies often deprioritize marginalized populations; (2) Technocratic policy design tends to overlook structural inequalities; (3) Integrated approaches that combine cost-effectiveness with equity considerations remain limited but are emerging in some contexts. Conclusion: this study emphasizes the need for health policies that balance efficiency with equity. Embedding social justice in health policy design is critical for ensuring that public health systems are both effective and fair. The findings call for a paradigm shift towards inclusive health governance that does not sacrifice justice for the sake of efficiency.