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Diagnosing Corruption in Ethiopia - Ethiomedia

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Overview 5<br />

for their knowledge of corruption <strong>in</strong> the sector <strong>in</strong> a range of countries.<br />

This mixture of approaches for the various sector-based surveys has<br />

attempted to get as unbiased and representative a view of each sector as<br />

possible, given the obvious resource constra<strong>in</strong>ts under which such an<br />

exercise must operate.<br />

Contributions of This Volume<br />

The book is structured along the l<strong>in</strong>es of the sector experts’ diagnostic<br />

work and divided <strong>in</strong>to eight chapters, one for each sector studied.<br />

Chapter 2: Health Sector <strong>Corruption</strong> <strong>in</strong> <strong>Ethiopia</strong><br />

William D. Savedoff and Karen Grép<strong>in</strong> identify and map the most common<br />

forms of corruption across the health sector through <strong>in</strong>terviews and<br />

analyses of public documentation and previously conducted surveys.<br />

Their analysis suggests that corruption <strong>in</strong> <strong>Ethiopia</strong>’s health sector is not<br />

as pervasive as <strong>in</strong> other countries or sectors. However, it also notes that<br />

recent developments, <strong>in</strong>clud<strong>in</strong>g the sector’s expansion and ris<strong>in</strong>g expenditures,<br />

could <strong>in</strong>crease the risk of corruption <strong>in</strong> the future, particularly <strong>in</strong><br />

the follow<strong>in</strong>g subsectors:<br />

Public f<strong>in</strong>ancial management. Limited oversight of the public procurement<br />

system, as well as weak compliance with audits and report<strong>in</strong>g<br />

requirements among both public and private <strong>in</strong>stitutions, has opened<br />

the sector to significant risk of corrupt practices.<br />

Human resources. The civil service employees who are responsible for<br />

regulat<strong>in</strong>g and <strong>in</strong>spect<strong>in</strong>g health care providers are poorly paid and<br />

tra<strong>in</strong>ed and thus tempted to request or accept bribes.<br />

Pharmaceuticals. Dual practice (<strong>in</strong> both public and private facilities or<br />

practices) by pharmacists and other health care workers is another significant<br />

concern, based on reports that health care workers take advantage<br />

of the public health care system by referr<strong>in</strong>g patients or divert<strong>in</strong>g<br />

supplies to more lucrative private practices.<br />

To address these risks, Savedoff and Grép<strong>in</strong> recommend that the<br />

government improve oversight <strong>in</strong>stitutions and mechanisms by systematiz<strong>in</strong>g<br />

audits, adequately resourc<strong>in</strong>g regulatory <strong>in</strong>stitutions, and ensur<strong>in</strong>g<br />

oversight and support of the Pharmaceutical Fund and Supply Agency.<br />

In addition, the authors recommend that the government regulate the<br />

relationship between the private and public health sectors by first del<strong>in</strong>eat<strong>in</strong>g<br />

acceptable and unacceptable ways for providers to comb<strong>in</strong>e their

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