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98 Fighting the Diseases of Povertypublic health care workers among users of health services based onsurvey data from various sources. The frequency range is enormousfrom 3 per cent in Peru to 96 per cent in Pakistan. Regionally SouthAsia stands out for its heavy reliance on informal payments. EastAsian experience is split between Thailand and Indonesia with lowlevels and the former Communist countries, with Cambodia at 55per cent and a dated estimate for Vietnam at 81 per cent. The proportionsfor Latin America and Eastern Europe have a wide distributionwith low levels in some countries and among the highest inothers, making generalizations meaningless. Recent evidence fromsmaller samples in Africa suggests that informal payments ofvarious kinds are common in Uganda (McPake et al., 1999), Mozambique(Lindelow, Ward and Zorzi, 2004) and Ethiopia (Lindelow,Serneels and Lemma, 2003). In all three, patients pay publicproviders directly for consultations and drugs over and above anyformal charges.Data sources vary with much of the information coming fromeither household surveys or governance and corruption studies,although some, like Bolivia (2002), Moldova, Kazakhstan (1999) andPoland used dedicated health facility exit surveys 5 , and Albania(2002), Bolivia (2001) and China used province level surveys, and theIndia data are from a district in Rajastan. Where both large householdsurveys and smaller studies exist for the same country, thelatter always shows higher informal payments. Kazakhstan exhibitsdramatically higher payments in the 2002 survey over the 2001LSMS. Albania’s overall LSMS estimate in 1996 was 22 per cent, butjumped to 28 and 60 per cent, respectively, for outpatient and inpatientcare in the smaller 2001 survey.Whether this is due to the greater attention to the issue withdedicated surveys and smaller samples that allow drilling down sufficientlyto obtain reliable information on a sensitive subject, orother factors it suggests that some of the broader surveys underestimatethe extent of patient payments.Low levels of informal payments in Peru, Paraguay, Thailandand Kosovo may reflect the existence of and reliance on private