Systems transform their current inputs into outputs to achieve their goals and objectives. Efficiency analysis is used to describe the degree to which a system achieves its goals using its resources. Pandemics similar to the Covid process may recur, and countries must use their existing resources more effectively in these struggles. The scope of this study was to evaluate the struggle of middle-income countries with Covid-19 within the scope of certain health indicators according to the World Bank's income classification by using the DEA, one of the methods used to measure the effectiveness of health systems. The ratio of GDP devoted to health services, the number of patient beds, the number of doctors per thousand population, the number of nurses and midwives per thousand population, and finally, the amount of health expenditure per capita were selected as the input variables in the study. The number of people recovering from Covid-19 disease per 100,000 people, total cases per 1 million people, total deaths per 1 million people, and total number of tests per million people were selected as the output variables in the study. The VZA input-oriented CCR model was used in the study. The reasons for the inefficiency of inefficient countries have been identified. In order for these countries to be located on the effective border, the targeted values have been revealed. Based on the efficient countries, potential improvements are made in the input values of the inefficient countries and the input values that can increase their efficiency are calculated. As a result of the study, 18 countries out of 47 countries were located in the effective border. Finally, the reasons for the inefficiency of the countries below the efficient frontier were calculated using the multiple linear regression analysis method, and the suggestions for necessary corrections were presented. The VZA input-oriented CCR model was used in the study. The reasons for the inefficiency of inefficient countries have been identified. In order for these countries to be located on the effective border, the targeted values have been revealed. Based on the efficient countries, potential improvements are made in the input values of the inefficient countries and the input values that can increase their efficiency are calculated. As a result of the study, 18 countries out of 47 countries were located in the effective border. Finally, the reasons for the inefficiency of the countries below the efficient frontier were calculated using the multiple linear regression analysis method, and the suggestions for necessary corrections were presented.