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Professionalism, Latent Professionalism and Organizational Demands for Health Care Quality in a Developing Country

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  • Leonard, Kenneth L.
  • Masatu, Melkiory C.

Abstract

Medicine is a professional pursuit, and even in developing countries professionalism should lead at least some practitioners to care for their patients despite the absence of direct incentives to do so. Even if practitioners do not behave as professionals, what is the extent of latent professionalism, in which socialization in the profession conditions health workers to respond to a demand for professionalism even if they do not normally act as professionals? How many health care workers in developing countries act as professionals all the time and what will happen if health services turn toward remuneration schemes in which health workers are paid by the output or outcome? We examine the behavior of 80 practitioners from Arusha region of Tanzania for evidence of latent professionalism, professionalism and responsiveness to extrinsic incentives in the form of organizational demands for high quality care. We show that about 20% of these practitioners act like professionals and almost half of these practice in the public sector. Professional health care workers provide high quality care even when they work in an environment that does not reward this effort, a finding that has important implications for the use of performance–based incentives.

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Bibliographic Info

Paper provided by University of Maryland, Department of Agricultural and Resource Economics in its series Working Papers with number 42883.

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Date of creation: 2008
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Handle: RePEc:ags:umdrwp:42883

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Related research

Keywords: incentives; quality; health care; professionalism; Tanzania; Health Economics and Policy; I1; O1; O2;

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References

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  1. John DiNardo & Justin L. Tobias, 2001. "Nonparametric Density and Regression Estimation," Journal of Economic Perspectives, American Economic Association, vol. 15(4), pages 11-28, Fall.
  2. Filmer, Deon & Hammer, Jeffrey S & Pritchett, Lant H, 2000. "Weak Links in the Chain: A Diagnosis of Health Policy in Poor Countries," World Bank Research Observer, World Bank Group, vol. 15(2), pages 199-224, August.
  3. George A. Akerlof & Rachel E. Kranton, 2000. "Economics And Identity," The Quarterly Journal of Economics, MIT Press, vol. 115(3), pages 715-753, August.
  4. Chaudhury, Nazmul & Hammer, Jeffrey S., 2003. "Ghost doctors - absenteeism in Bangladeshi health facilities," Policy Research Working Paper Series 3065, The World Bank.
  5. Das, Jishnu & Hammer, Jeffrey, 2004. "Which doctor? Combining vignettes and item response to measure doctor quality," Policy Research Working Paper Series 3301, The World Bank.
  6. Reinikka, Ritva & Svensson, Jakob, 2004. "Working for God?," CEPR Discussion Papers 4214, C.E.P.R. Discussion Papers.
  7. Leonard, Kenneth L., 2002. "When both states and markets fail: asymmetric information and the role of NGOs in African health care," International Review of Law and Economics, Elsevier, vol. 22(1), pages 61-80, July.
  8. Ottar Mæstad & Gaute Torsvik, 2008. "Improving the Quality of Health Care when Health Workers are in Short Supply," CMI Working Papers 12, CMI (Chr. Michelsen Institute), Bergen, Norway.
  9. Bruno S. Frey & Reto Jegen, 2000. "Motivation Crowding Theory: A Survey of Empirical Evidence," CESifo Working Paper Series 245, CESifo Group Munich.
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Cited by:
  1. Lewis, Maureen & Pettersson, Gunilla, 2009. "Governance in health care delivery : raising performance," Policy Research Working Paper Series 5074, The World Bank.

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