IDEAS home Printed from https://ideas.repec.org/p/upf/upfgen/989.html
   My bibliography  Save this paper

For public service or money: Understanding geographical imbalances in the health workforce in Ethiopia

Author

Listed:

Abstract

Geographical imbalances in the health workforce have been a consistent feature of nearly all health systems, and especially in developing countries. In this paper we investigate the willingness to work in a rural area among final year nursing and medical students in Ethiopia. Analyzing data obtained from contingent valuation questions, we find that household consumption and the student’s motivation to help the poor, which is our proxy for intrinsic motivation, are the main determinants of willingness to work in a rural area. We investigate whoe is willing to help the poor and find that women are significantly more likely than men. Other variables, including a rich set of psychosocial characteristics, are not significant. Finally, we carry out some simulation on how much it would cost to make the entire cohort of starting nurses and doctors chooseto take up a rural post.

Suggested Citation

  • Pieter Serneels & Magnus Lindelow & José Garcia Montalvo & Abigail Barr, 2006. "For public service or money: Understanding geographical imbalances in the health workforce in Ethiopia," Economics Working Papers 989, Department of Economics and Business, Universitat Pompeu Fabra.
    • Handle: RePEc:upf:upfgen:989
    as

    Download full text from publisher

    File URL: https://econ-papers.upf.edu/papers/989.pdf
    File Function: Whole Paper
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Ernst Fehr & Urs Fischbacher, "undated". "Third Party Punishment and Social Norms," IEW - Working Papers 106, Institute for Empirical Research in Economics - University of Zurich.
    2. Lindelow, Magnus & Serneels, Pieter, 2006. "The performance of health workers in Ethiopia: Results from qualitative research," Social Science & Medicine, Elsevier, vol. 62(9), pages 2225-2235, May.
    3. Ernst Fehr & Simon Gachter & Georg Kirchsteiger, 1997. "Reciprocity as a Contract Enforcement Device: Experimental Evidence," Econometrica, Econometric Society, vol. 65(4), pages 833-860, July.
    4. J Hurley, 1990. "Simulated Effects of Incomes-based Policies on the Distribution of Physicians," Centre for Health Economics and Policy Analysis Working Paper Series 11, Centre for Health Economics and Policy Analysis (CHEPA), McMaster University, Hamilton, Canada.
    5. T.A. Cameron & D.D. Huppert, 1988. ""Referendum" Contingent Valuation Estimates: Sensitivity to the Assignment of Offered Values," UCLA Economics Working Papers 519, UCLA Department of Economics.
    6. Bolduc, Denis & Fortin, Bernard & Fournier, Marc-Andre, 1996. "The Effect of Incentive Policies on the Practice Location of Doctors: A Multinomial Probit Analysis," Journal of Labor Economics, University of Chicago Press, vol. 14(4), pages 703-732, October.
    7. Alberini Anna, 1995. "Efficiency vs Bias of Willingness-to-Pay Estimates: Bivariate and Interval-Data Models," Journal of Environmental Economics and Management, Elsevier, vol. 29(2), pages 169-180, September.
    8. George A. Akerlof & Rachel E. Kranton, 2000. "Economics and Identity," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 115(3), pages 715-753.
    9. Grosh, M.E. & Baker, J.L., 1995. "Proxy Means Tests for Targetting Social Programs. Simulations and Speculation," Papers 118, World Bank - Living Standards Measurement.
    10. Michael Lockwood, 1998. "Contribution of Contingent Valuation and Other Stated Preference Methods to Evaluation of Environmental Policy," Australian Economic Papers, Wiley Blackwell, vol. 37(3), pages 292-311, September.
    11. Franco, Lynne Miller & Bennett, Sara & Kanfer, Ruth, 2002. "Health sector reform and public sector health worker motivation: a conceptual framework," Social Science & Medicine, Elsevier, vol. 54(8), pages 1255-1266, April.
    12. 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.
    13. Edward L. Glaeser & David I. Laibson & José A. Scheinkman & Christine L. Soutter, 2000. "Measuring Trust," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 115(3), pages 811-846.
      • Glaeser, Edward Ludwig & Laibson, David I. & Scheinkman, Jose A. & Soutter, Christine L., 2000. "Measuring Trust," Scholarly Articles 4481497, Harvard University Department of Economics.
    14. Kristiansen, Ivar Sønbø & Førde, Olav Helge, 1992. "Medical specialists' choice of location: The role of geographical attachment in Norway," Social Science & Medicine, Elsevier, vol. 34(1), pages 57-62, January.
    15. Jeffrey Carpenter & Erika Seki, 2011. "Do Social Preferences Increase Productivity? Field Experimental Evidence From Fishermen In Toyama Bay," Economic Inquiry, Western Economic Association International, vol. 49(2), pages 612-630, April.
    16. Stéphane Luchini & Christel Protière & Jean‐Paul Moatti, 2003. "Eliciting several willingness to pay in a single contingent valuation survey: application to health care," Health Economics, John Wiley & Sons, Ltd., vol. 12(1), pages 51-64, January.
    17. Cameron Trudy Ann & Quiggin John, 1994. "Estimation Using Contingent Valuation Data from a Dichotomous Choice with Follow-Up Questionnaire," Journal of Environmental Economics and Management, Elsevier, vol. 27(3), pages 218-234, November.
    18. Kreps, David M, 1997. "Intrinsic Motivation and Extrinsic Incentives," American Economic Review, American Economic Association, vol. 87(2), pages 359-364, May.
    19. Abigail Barr & Pieter Serneels, 2009. "Reciprocity in the workplace," Experimental Economics, Springer;Economic Science Association, vol. 12(1), pages 99-112, March.
    20. Cam Donaldson & Phil Shackley & Mona Abdalla, 1997. "Using Willingness To Pay To Value Close Substitutes: Carrier Screening for Cystic Fibrosis Revisited," Health Economics, John Wiley & Sons, Ltd., vol. 6(2), pages 145-159, March.
    21. Lindelow, Magnus & Serneels, Pieter, 2006. "The performance of health workers in Ethiopia: Results from qualitative research," Social Science & Medicine, Elsevier, vol. 62(9), pages 2225-2235, May.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Pieter Serneels & Abigail Barr & Magnus Lindelow, 2005. "Understanding Geographical Imbalances in the Health Workforce," Economics Series Working Papers GPRG-WPS-018, University of Oxford, Department of Economics.
    2. Serneels, Pieter & Lindelow, Magnus & Garcia-Montalvo, Jose & Barr, Abigail, 2005. "For public service or money : understanding geographical imbalances in the health workforce," Policy Research Working Paper Series 3686, The World Bank.
    3. Pieter Serneels & Jose G. Montalvo & Gunilla Pettersson & Tomas Lievens & Jean Damascene Butera & Aklilu Kidanu, 2010. "Who Wants to Work in a Rural Health Post? The Role of Intrinsic Motivation, Rural Background and Faith-Based Institutions in Rwanda and Ethiopia," CSAE Working Paper Series 2010-10, Centre for the Study of African Economies, University of Oxford.
    4. Sandra Nocera & Gabrielle Wanzenried, 2002. "On the Dynamics of Physician Density; Theory and Empirical Evidence for Switzerland," Diskussionsschriften dp0208, Universitaet Bern, Departement Volkswirtschaft.
    5. Isabel Correia & Paula Veiga, 2010. "Geographic distribution of physicians in Portugal," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 11(4), pages 383-393, August.
    6. Samuel Bowles & Sandra Polania-Reyes, 2011. "Economic incentives and social preferences: substitutes or complements?," Department of Economics University of Siena 617, Department of Economics, University of Siena.
    7. Sauermann, Jan, 2015. "Worker Reciprocity and the Returns to Training: Evidence from a Field Experiment," IZA Discussion Papers 9179, Institute of Labor Economics (IZA).
    8. Bracht, Juergen & Feltovich, Nick, 2009. "Whatever you say, your reputation precedes you: Observation and cheap talk in the trust game," Journal of Public Economics, Elsevier, vol. 93(9-10), pages 1036-1044, October.
    9. Matteo M. Galizzi & Daniel Navarro-Martinez, 2019. "On the External Validity of Social Preference Games: A Systematic Lab-Field Study," Management Science, INFORMS, vol. 65(3), pages 976-1002, March.
    10. Rebitzer, James B. & Taylor, Lowell J., 2011. "Extrinsic Rewards and Intrinsic Motives: Standard and Behavioral Approaches to Agency and Labor Markets," Handbook of Labor Economics, in: O. Ashenfelter & D. Card (ed.), Handbook of Labor Economics, edition 1, volume 4, chapter 8, pages 701-772, Elsevier.
    11. Brice Corgnet & Brian Gunia & Roberto Hernán González, 2021. "Harnessing the power of social incentives to curb shirking in teams," Journal of Economics & Management Strategy, Wiley Blackwell, vol. 30(1), pages 139-167, February.
    12. Stefano Bartolini & Ennio Bilancini & Maurizio Pugno, 2013. "Did the Decline in Social Connections Depress Americans’ Happiness?," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 110(3), pages 1033-1059, February.
    13. Richard Carson & Nicholas Flores & Norman Meade, 2001. "Contingent Valuation: Controversies and Evidence," Environmental & Resource Economics, Springer;European Association of Environmental and Resource Economists, vol. 19(2), pages 173-210, June.
    14. Andreas Leibbrandt, 2012. "Are social preferences related to market performance?," Experimental Economics, Springer;Economic Science Association, vol. 15(4), pages 589-603, December.
    15. Richard T. Carson, 2011. "Contingent Valuation," Books, Edward Elgar Publishing, number 2489.
    16. Shchetinin, Oleg, 2009. "Contracting Under Reciprocal Altruism," MPRA Paper 13457, University Library of Munich, Germany.
    17. Antoine Billot & Chantal Marlats, 2009. "Préferences psychologiques et nouvelle économie politique," Working Papers halshs-00566146, HAL.
    18. Fali Huang & Peter Cappelli, 2006. "Employee Screening: Theory and Evidence," NBER Working Papers 12071, National Bureau of Economic Research, Inc.

    More about this item

    Keywords

    Health care delivery; health workers; labour supply; public service;
    All these keywords.

    JEL classification:

    • D1 - Microeconomics - - Household Behavior
    • J22 - Labor and Demographic Economics - - Demand and Supply of Labor - - - Time Allocation and Labor Supply
    • J64 - Labor and Demographic Economics - - Mobility, Unemployment, Vacancies, and Immigrant Workers - - - Unemployment: Models, Duration, Incidence, and Job Search

    NEP fields

    This paper has been announced in the following NEP Reports:

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:upf:upfgen:989. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: the person in charge (email available below). General contact details of provider: http://www.econ.upf.edu/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.