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Informal payments in government health facilities in Albania: Results of a qualitative study

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  • Vian, Taryn
  • Grybosk, Kristina
  • Sinoimeri, Zamira
  • Hall, Rachel

Abstract

As governments seek to expand access to quality health care services, policy makers in many countries are confronting the problem of informal payments to medical personnel. The aim of this study was to help health planners in Albania understand informal payments occurring in government health facilities. Researchers used in-depth interviews and focus groups with 131 general public and provider informants in three districts. The results suggest that factors promoting informal payments in Albania include perceived low salaries of health staff; a belief that good health is worth any price; the desire to get better service; the fear of being denied treatment; and the tradition of giving a gift to express gratitude. Members of the general public also believe informal payments create uncertainties and anxiety during the care-seeking process, while providers perceive that informal payments harm their professional reputation, induce unnecessary medical interventions, and create discontinuity of care. The study showed that focusing on the most harmful effects and targeting the most vulnerable populations may be one way to gain consensus for policy reform. Understanding citizens' and caregivers' viewpoints is an important step in designing regulatory and bureaucratic interventions.

Suggested Citation

  • Vian, Taryn & Grybosk, Kristina & Sinoimeri, Zamira & Hall, Rachel, 2006. "Informal payments in government health facilities in Albania: Results of a qualitative study," Social Science & Medicine, Elsevier, vol. 62(4), pages 877-887, February.
  • Handle: RePEc:eee:socmed:v:62:y:2006:i:4:p:877-887
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    References listed on IDEAS

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    Citations

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    Cited by:

    1. Sonila Tomini & Wim Groot & Milena Pavlova, 2012. "Paying informally in the Albanian health care sector: a two-tiered stochastic frontier model," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 13(6), pages 777-788, December.
    2. Onwujekwe, Obinna & Dike, Nkem & Uzochukwu, Benjamin & Ezeoke, Ogochukwu, 2010. "Informal payments for healthcare: Differences in expenditures from consumers and providers perspectives for treatment of malaria in Nigeria," Health Policy, Elsevier, vol. 96(1), pages 72-79, June.
    3. repec:eee:hepoli:v:121:y:2017:i:10:p:1053-1062 is not listed on IDEAS
    4. World Bank, 2011. "Albania - Out-of-Pocket Payments in Albania’s Health System : Trends in Household Perceptions and Experiences 2002-2008," World Bank Other Operational Studies 2784, The World Bank.
    5. Arsenijevic, Jelena & Pavlova, Milena & Groot, Wim, 2013. "Measuring the catastrophic and impoverishing effect of household health care spending in Serbia," Social Science & Medicine, Elsevier, vol. 78(C), pages 17-25.
    6. Hyacinthe Tchewonpi Kankeu & Sylvie Boyer & Raoul Fodjo Toukam & Mohammad Abu-Zaineh, 2016. "How do supply-side factors influence informal payments for healthcare? The case of HIV patients in Cameroon," International Journal of Health Planning and Management, Wiley Blackwell, vol. 31(1), pages 41-57, January.
    7. Arsenijevic, Jelena & Pavlova, Milena & Groot, Wim, 2015. "Out-of-pocket payments for health care in Serbia," Health Policy, Elsevier, vol. 119(10), pages 1366-1374.
    8. repec:kap:ijhcfe:v:17:y:2017:i:3:d:10.1007_s10754-016-9203-7 is not listed on IDEAS
    9. Tina Søreide, 2014. "Drivers of Corruption : A Brief Review," World Bank Publications, The World Bank, number 20457, November.
    10. Liaropoulos, Lycourgos & Siskou, Olga & Kaitelidou, Daphne & Theodorou, Mamas & Katostaras, Theofanis, 2008. "Informal payments in public hospitals in Greece," Health Policy, Elsevier, vol. 87(1), pages 72-81, July.
    11. Mæstad, Ottar & Mwisongo, Aziza, 2011. "Informal payments and the quality of health care: Mechanisms revealed by Tanzanian health workers," Health Policy, Elsevier, vol. 99(2), pages 107-115, February.
    12. Grigorakis, Nikolaos & Floros, Christos & Tsangari, Haritini & Tsoukatos, Evangelos, 2016. "Out of pocket payments and social health insurance for private hospital care: Evidence from Greece," Health Policy, Elsevier, vol. 120(8), pages 948-959.
    13. Cherecheş, Răzvan M. & Ungureanu, Marius I. & Sandu, Petru & Rus, Ioana A., 2013. "Defining informal payments in healthcare: A systematic review," Health Policy, Elsevier, vol. 110(2), pages 105-114.
    14. Sonila M. Tomini & Wim Groot, 2013. "Paying informally for public health care in Albania: scarce resources or governance failure?," Applied Economics, Taylor & Francis Journals, vol. 45(36), pages 5119-5130, December.
    15. Kaitelidou, Daphne Ch. & Tsirona, Christina S. & Galanis, Petros A. & Siskou, Olga Ch. & Mladovsky, Philipa & Kouli, Eugenia G. & Prezerakos, Panagiotis E. & Theodorou, Mamas & Sourtzi, Panagiota A. &, 2013. "Informal payments for maternity health services in public hospitals in Greece," Health Policy, Elsevier, vol. 109(1), pages 23-30.
    16. Kankeu, Hyacinthe Tchewonpi & Ventelou, Bruno, 2016. "Socioeconomic inequalities in informal payments for health care: An assessment of the ‘Robin Hood’ hypothesis in 33 African countries," Social Science & Medicine, Elsevier, vol. 151(C), pages 173-186.
    17. Tomini, Sonila & Groot, Wim, 2012. "Paying informally for public health care in Albania: scarce resources or governance failure?," MERIT Working Papers 070, United Nations University - Maastricht Economic and Social Research Institute on Innovation and Technology (MERIT).

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