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Overview 5
for their knowledge of corruption in the sector in a range of countries.
This mixture of approaches for the various sector-based surveys has
attempted to get as unbiased and representative a view of each sector as
possible, given the obvious resource constraints under which such an
exercise must operate.
Contributions of This Volume
The book is structured along the lines of the sector experts’ diagnostic
work and divided into eight chapters, one for each sector studied.
Chapter 2: Health Sector Corruption in Ethiopia
William D. Savedoff and Karen Grépin identify and map the most common
forms of corruption across the health sector through interviews and
analyses of public documentation and previously conducted surveys.
Their analysis suggests that corruption in Ethiopia’s health sector is not
as pervasive as in other countries or sectors. However, it also notes that
recent developments, including the sector’s expansion and rising expenditures,
could increase the risk of corruption in the future, particularly in
the following subsectors:
• Public financial management. Limited oversight of the public procurement
system, as well as weak compliance with audits and reporting
requirements among both public and private institutions, has opened
the sector to significant risk of corrupt practices.
• Human resources. The civil service employees who are responsible for
regulating and inspecting health care providers are poorly paid and
trained and thus tempted to request or accept bribes.
• Pharmaceuticals. Dual practice (in both public and private facilities or
practices) by pharmacists and other health care workers is another significant
concern, based on reports that health care workers take advantage
of the public health care system by referring patients or diverting
supplies to more lucrative private practices.
To address these risks, Savedoff and Grépin recommend that the
government improve oversight institutions and mechanisms by systematizing
audits, adequately resourcing regulatory institutions, and ensuring
oversight and support of the Pharmaceutical Fund and Supply Agency.
In addition, the authors recommend that the government regulate the
relationship between the private and public health sectors by first delineating
acceptable and unacceptable ways for providers to combine their