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

Author

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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.

Suggested Citation

  • 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.
  • Handle: RePEc:ags:umdrwp:42883
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    File URL: http://purl.umn.edu/42883
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    References listed on IDEAS

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    1. 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.
    2. Leonard, Kenneth L. & Masatu, Melkiory C., 2008. "Moving from the lab to the field: Exploring scrutiny and duration effects in lab experiments," Economics Letters, Elsevier, vol. 100(2), pages 284-287, August.
    3. Reinikka, Ritva & Svensson, Jakob, 2004. "Working for God?," CEPR Discussion Papers 4214, C.E.P.R. Discussion Papers.
    4. Mæstad, Ottar & Torsvik, Gaute, 2008. "Improving the quality of health care when health workers are in short supply," Working Papers in Economics 14/08, University of Bergen, Department of Economics.
    5. 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.
    6. Chaudhury, Nazmul & Hammer, Jeffrey S., 2003. "Ghost doctors - absenteeism in Bangladeshi health facilities," Policy Research Working Paper Series 3065, The World Bank.
    7. 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.
    8. Bruno S. Frey & Reto Jegen, 2000. "Motivation Crowding Theory: A Survey of Empirical Evidence," CESifo Working Paper Series 245, CESifo Group Munich.
    9. George A. Akerlof & Rachel E. Kranton, 2000. "Economics and Identity," The Quarterly Journal of Economics, Oxford University Press, vol. 115(3), pages 715-753.
    10. 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.
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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.

    More about this item

    Keywords

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

    JEL classification:

    • I1 - Health, Education, and Welfare - - Health
    • O1 - Economic Development, Innovation, Technological Change, and Growth - - Economic Development
    • O2 - Economic Development, Innovation, Technological Change, and Growth - - Development Planning and Policy

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