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Corruption in public health 81 Figure 2 Percent perceiving corruption in the health sector Pakistan (2002) Sri Lanka (2001) Tajikistan (2001) Moldova (2000) Morroco (2001) Serbia (2002) Madagascar (2001) Bolivia (2001) Albania (2002) Slovakia (2000) Macedonia (2002) Croatia (2002) Romania (2000) Bulgaria (2002) Senegal (2001) Bosnia (2000) Kyrgyz (2001) Bangladesh (2002) Peru (2001) Kazakhstan (2001) 0 10 20 30 40 50 60 70 80 90 100 Source: Appendix I exist (Thampi, 2002; McPake et. al 1999; Lewis, 2000, 2002; Narayan, 2000). While not definitive, perceptions highlight where abuses are assumed and widespread and they have become reliable indicators of corruption. Only a few countries have sector specific data on perceptions. Greater efforts to track such information can guide both policymakers and donors providing a benchmark for individual countries.
82 Fighting the Diseases of Poverty Staffing health care delivery Staffing is arguably the single most important element of health care delivery as little can be achieved without it. Training of the staff, their competencies and ability to function all determine whether labor can drive the expected results. Training typically is adequate if not well beyond that needed in the lowest income countries, especially for physicians. Availability of the full range of competencies, however, often lags with particular inattention to management needs, and lower paid staff with minimal skills can proliferate. Among the most serious issues in developing countries is the high rate of absenteeism, which undermines service delivery and leads to closed public clinics that compromise the equity and health objectives of publicly financed health care. Two other commonly observed constraints include low productivity of public medical staff, and the outright corruption that underlies the buying and selling of official positions. Capturing low productivity and poor service poses greater difficulties; absenteeism already reflects reduced output, and underperformance. Patient satisfaction provides an additional window into adequacy of staff services. Absenteeism Absenteeism poses a chronic, but often unmeasured, problem in publicly financed health care, and can severely limit patient access to services (McPake et. al., 1999; Lewis, Eskeland and Traa-Valarezo, 2004; Narayan, 2000), reduce quality (McPake et. al., 1999; Lewis, La Forgia and Sulvetta, 1996), and suggest corruption (DiTella and Savedoff, 2001). Absenteeism occurs for various reasons, many of them legitimate or necessary. For example, rural health workers often need to travel to larger towns to receive their paycheck, fetch supplies or drugs or are delayed by poor infrastructure or weather. All lead to absences but are necessitated by inadequate management or other shortcoming of the country con<strong>text</strong>. On the other hand, some staff have other commitments or preferences and don’t show up. In effect they
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Fighting the Diseases of Poverty Ed
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About International Policy Network
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Fighting the Diseases of Poverty Ed
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The authors Johan Biermann is a pla
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The authors ix Maureen has publishe
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xii Fighting the Diseases of Povert
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xviii Fighting the Diseases of Pove
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xx Fighting the Diseases of Poverty
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6 Cost effective means of fighting
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Counterfeit medicines in LDCs: prob
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The value of vaccination 215 In the
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The value of vaccination 217 the di
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The value of vaccination 219 ◆
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The value of vaccination 221 Figure
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The value of vaccination 223 vaccin
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The value of vaccination 225 moreov
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The value of vaccination 227 encour
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The value of vaccination 229 packag
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The value of vaccination 231 longer
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The value of vaccination 233 2005 t
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The value of vaccination 235 long-t
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The value of vaccination 237 Table
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9 The World Health Organisation: a
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The World Health Organisation: a ti
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Notes Introduction 1 The UN Human D
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Notes 267 18 The decline in their G
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Notes 269 4 The diseases of poverty
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Notes 271 to high-levels of researc
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Notes 273 to register new products,
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Notes 275 2 Snow, B et al., “The
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Sources 277 Karoly, L., Greenwood,
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Sources 279 ——— . 2004. The S
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Sources 281 University, March 13. A
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Sources 283 Alcazar, L and Andrade,
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Sources 285 Di Tella, R. and Savedo
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Sources 287 La Forgia, G. 2005. Hea
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Sources 289 Shishkin, Sergey. 2003.
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Sources 291 4 The diseases of pover
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Sources 293 Wofford, D., & Shanahan
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Sources 295 6 Cost effective means
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Sources 297 7 Counterfeit medicines
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The Campaign for Fighting Diseases
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Dr. Henry I. Miller joined the Food
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