The performance of health workers in Ethiopia - results from qualitative research
Insufficient attention has been paid to understanding what determines the performance of health workers and how they make labor market choices. This paper reports on findings from focus group discussions with both health workers and users of health services in Ethiopia, a country with some of the poorest health outcomes in the world. It describes performance problems identified by both health, users and health workers participating in the focus group discussions, including absenteeism and shirking, pilfering drugs and materials, informal health care provision and illicit charging, and corruption. The second part of the paper presents four structural reasons why these problems arise: (1) the ongoing transition from a health sector dominated by the public sector, toward a more mixed model; (2) the failure of government policies to keep pace with the transition toward a mixed model of service delivery; (3) weak accountability mechanisms and the erosion of professional norms in the health sector; and (4) the impact of HIV/AIDS. The discussions underline the need to base policies on a micro-analysis of how health workers make constrained choices, both in their career and in their day to day professional activities.
|Date of creation:||01 Apr 2005|
|Contact details of provider:|| Postal: 1818 H Street, N.W., Washington, DC 20433|
Phone: (202) 477-1234
Web page: http://www.worldbank.org/
More information through EDIRC
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.:
- 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.
- McPake, Barbara & Asiimwe, Delius & Mwesigye, Francis & Ofumbi, Mathias & Ortenblad, Lisbeth & Streefland, Pieter & Turinde, Asaph, 1999. "Informal economic activities of public health workers in Uganda: implications for quality and accessibility of care," Social Science & Medicine, Elsevier, vol. 49(7), pages 849-865, October.
- Ensor, Tim & Witter, Sophie, 2001. "Health economics in low income countries: adapting to the reality of the unofficial economy," Health Policy, Elsevier, vol. 57(1), pages 1-13, July.
- Belli, Paolo & Gotsadze, George & Shahriari, Helen, 2004. "Out-of-pocket and informal payments in health sector: evidence from Georgia," Health Policy, Elsevier, vol. 70(1), pages 109-123, October.
- Ensor, Tim, 2004. "Informal payments for health care in transition economies," Social Science & Medicine, Elsevier, vol. 58(2), pages 237-246, January.
- Yach, Derek, 1992. "The use and value of qualitative methods in health research in developing countries," Social Science & Medicine, Elsevier, vol. 35(4), pages 603-612, August.