The Performance of Health Workers in Ethiopia Results from Qualitative Research

21 Pages Posted: 22 Apr 2005

See all articles by Magnus Lindelow

Magnus Lindelow

World Bank

Pieter M. Serneels

University of Oxford - Centre for the Study of African Economies (CSAE)

Teigist Lemma

International Labour Organization, Addis Ababa

Date Written: April 2005

Abstract

Insufficient attention has been paid to understanding what determines the performance of health workers and how they make labor market choices. This paper reports on findings from focus group discussions with both health workers and users of health services in Ethiopia, a country with some of the poorest health outcomes in the world. We describe performance problems identified by both health users and health workers participating in the focus group discussions, including absenteeism and shirking, pilfering drugs and materials, informal health care provision and illicit charging, and corruption. In the second part of the paper we present four structural reasons why these problems arise: (i) the ongoing transition from a health sector dominated by the public sector, toward a more mixed model; (ii) the failure of government policies to keep pace with the transition toward a mixed model of service delivery; (iii) weak accountability mechanisms and the erosion of professional norms in the health sector; and (iv) the impact of HIV/AIDS. The discussions underline the need to base policies on a micro-analysis of how health workers make constrained choices, both in their career and in their day to day professional activities.

Keywords: health worker performance, human resources for health, corruption

JEL Classification: J44, E19

Suggested Citation

Lindelow, Magnus and Serneels, Pieter M. and Lemma, Teigist, The Performance of Health Workers in Ethiopia Results from Qualitative Research (April 2005). World Bank Policy Research Working Paper No. 3558. Available at SSRN: https://ssrn.com/abstract=708424

Magnus Lindelow (Contact Author)

World Bank ( email )

1818 H Street, N.W.
Washington, DC 20433
United States

Pieter M. Serneels

University of Oxford - Centre for the Study of African Economies (CSAE) ( email )

Oxford OX1 3UL
United Kingdom

Teigist Lemma

International Labour Organization, Addis Ababa

Route des Morillons 4
Geneva, 1211
Switzerland

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