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Ghost doctors - absenteeism in Bangladeshi health facilities

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Author Info
Chaudhury, Nazmul
Hammer, Jeffrey S.

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Abstract

The authors report on a study in which unannounced visits were made to health clinics in Bangladesh with the intention of discovering what fraction of medical professionals were present at their assigned post. This survey represents the first attempt to quantify the extent of the problem on a nationally representative scale. Nationwide the average number of vacancies over all types of providers in rural health centers is 26 percent. Regionally, vacancy rates (unfilled posts) are generally higher in the poorer parts of the country. Absentee rates at over 40 percent are particularly high for doctors. When separated into level of facility, the absentee rate for doctors at the larger clinics is 40 percent, but at the smaller sub-centers with a single doctor, the rate is 74 percent. Even though the primary purpose of this survey is to document the extent of the problem among medical staff, the authors also explore the determinants of staff absenteeism. Whether the medical provider lives near the health facility, access to a road, and rural electrification are important determinants of the rate and pattern of staff absentee rates.

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Paper provided by The World Bank in its series Policy Research Working Paper Series with number 3065.

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Date of creation: 31 May 2003
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Handle: RePEc:wbk:wbrwps:3065

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Keywords: Public Health Promotion; Gender and Health; Health Systems Development&Reform; Health Monitoring&Evaluation; Housing&Human Habitats; Health Systems Development&Reform; Health Monitoring&Evaluation; Housing&Human Habitats; Gender and Health; Agricultural Knowledge&Information Systems;

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This paper has been announced in the following NEP Reports: References listed on IDEAS
Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:
  1. Hammer, Jeffrey S, 1997. "Economic Analysis for Health Projects," World Bank Research Observer, Oxford University Press, vol. 12(1), pages 47-71, February. [Downloadable!]
    Other versions:
  2. Swamy, Anand & Knack, Stephen & Lee, Young & Azfar, Omar, 2001. "Gender and corruption," Journal of Development Economics, Elsevier, vol. 64(1), pages 25-55, February. [Downloadable!] (restricted)
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  3. Dollar, David & Fisman, Raymond & Gatti, Roberta, 2001. "Are women really the "fairer" sex? Corruption and women in government," Journal of Economic Behavior & Organization, Elsevier, vol. 46(4), pages 423-429, December. [Downloadable!] (restricted)
  4. Reinikka, Ritva & Svensson, Jakob, 2001. "Explaining leakage of public funds," Policy Research Working Paper Series 2709, The World Bank. [Downloadable!]
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  5. Chomitz, Kenneth M. & Setiadi, Gunawan & Azwar, Azrul & Ismail, Nusye & Widiyarti, 1998. "What do doctors want? developing incentives for doctors to serve in Indonesia's rural and remote areas," Policy Research Working Paper Series 1888, The World Bank. [Downloadable!]
  6. Thomas, D. & Lavy, V. & Strauss, J., 1992. "Public Policy and Anthropometric Outcomes in Cote d'Ivoire," Papers 89, World Bank - Living Standards Measurement.
  7. Leonard, Kenneth L., 2003. "African traditional healers and outcome-contingent contracts in health care," Journal of Development Economics, Elsevier, vol. 71(1), pages 1-22, June. [Downloadable!] (restricted)
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  8. 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, Oxford University Press, vol. 15(2), pages 199-224, August.
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(explanations, Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.)

  1. Abhijit Banerjee & Angus Deaton & Esther Duflo, 2004. "Health Care Delivery in Rural Rajasthan," Natural Field Experiments 0016, The Field Experiments Website. [Downloadable!]
  2. Das, Jishnu & Dercon, Stefan & Habyarimana, James & Krishnan, Pramila, 2005. "Teacher shocks and student learning : evidence from Zambia," Policy Research Working Paper Series 3602, The World Bank. [Downloadable!]
    Other versions:
  3. Klemick, Heather & Leonard, Kenneth L. & Masatu, Melkiory C., 2008. "Defining Access to Health Care: Evidence on the Importance of Quality and Distance in Rural Tanzania," Working Papers 6178, University of Maryland, Department of Agricultural and Resource Economics. [Downloadable!]
  4. Leonard, Kenneth L. & Masatu, Melkiory C., 2008. "Professionalism, Latent Professionalism and Organizational Demands for Health Care Quality in a Developing Country," Working Papers 42883, University of Maryland, Department of Agricultural and Resource Economics. [Downloadable!]
  5. Reinikka, Ritva & Svensson, Jakob, 2003. "Survey techniques to measure and explain corruption," Policy Research Working Paper Series 3071, The World Bank. [Downloadable!]
  6. Abhijit Banerjee & Angus Deaton & Esther Duflo, 2004. "Wealth, Health, and Health Services in Rural Rajasthan," American Economic Review, American Economic Association, vol. 94(2), pages 326-330, May. [Downloadable!]
    Other versions:
  7. Das, Jishnu & Hammer, Jeffrey, 2005. "Money for nothing : the dire straits of medical practice in Delhi, India," Policy Research Working Paper Series 3669, The World Bank. [Downloadable!]
    Other versions:
  8. Leonard, Kenneth L. & Masatu, Melkiory C., 2008. "Using the Hawthorne Effect to Examine the Gap Between a Doctor's Best Possible Practice and Actual Performance," Working Papers 36693, University of Maryland, Department of Agricultural and Resource Economics. [Downloadable!]
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