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54 Diagnosing Corruption in Ethiopia
Finally, some informants mentioned that the influx of donor funding
has contributed to the high turnover of public sector employees—in particular,
the staff involved in the monitoring and reporting on financial
flows—and the diversion of staff for travel and training purposes. Many
interviewees cited the high turnover as the main reason for a lack of
capacity in the financial management process.
In the Tigray region, regional health officials have limited the per
diems that can be paid by government or outside agencies to keep some
control over their employees. However, per diems from HIV/AIDS organizations
have been exempted from this practice, and those we interviewed
could not explain why. Donor organizations should be encouraged
to abide by local standards where possible, avoid excessive recruitment of
technically trained employees, and provide stronger justification for such
workshops and training.
Next Steps
The weakness of Ethiopia’s health care system appears to have more to
do with limited resources and inefficiency than with corruption.
Ethiopians do not generally have good or equitable access to health care,
but this is largely due to constraints on financial and human resources.
Fortunately, Ethiopia is receiving increasing resources to strengthen its
health sector and expand service provision. The government is also
undertaking many reforms and programs to improve the efficiency and
integrity of public health care provision. Many of these reforms will
simultaneously curtail corruption, though some also present risks.
Public sector modernization is advancing on a number of fronts that
could substantially reduce opportunities for corruption. These advances
include the following reforms:
• Public procurement reforms. Application of the PPA to all public procurement
is improving procurement practices and transparency.
• Pharmaceutical Fund and Supply Agency. The PFSA is assuming responsibility
for the procurement, management, distribution, and control of
all pharmaceuticals and supplies used in the public sector.
• Business process reengineering. BPR is being implemented in federal
and regional public administrations responsible for health care provision
to improve personnel management, performance, and
accountability.