Leakage of Public Resources in the Health Sector : An Empirical Investigation of Chad

Gauthier, Bernard ; Wane, Waly

关键词: ACCESS TO HEALTH SERVICES;    ACCOUNTABILITY;    ACCOUNTING;    ADULT ILLITERACY;    ALLOCATING PUBLIC RESOURCES;   

DOI  :  10.1596/1813-9450-4351
RP-ID  :  WPS4351

学科分类：社会科学、人文和艺术（综合）

来源: World Bank Open Knowledge Repository

【 摘 要 】

In the public sector in developingcountries, leakage of public resources could provedetrimental to users and affect the well-being of thepopulation. This paper empirically examines the importanceof leakage of government resources in the health sector inChad, and its effects on the prices of drugs.The analysisuses data collected in Chad as part of a Health FacilitiesSurvey organized by the World Bank in 2004. The surveycovered 281 primary health care centers and containedinformation on the provision of medical material, financialresources, and medicines allocated by the Ministry of Healthto the regional administration and primary health centers.Although the regional administration is officially allocated60 percent of the ministry's non-wage recurrentexpenditures, the share of the resources that actually reachthe regions is estimated to be only 18 percent. The healthcenters, which are the frontline providers and the entrypoint for the population, receive less than 1 percent of theministry's non-wage recurrent expenditures. Accountingfor the endogeneity of the level of competition among healthcenters, the leakage of government resources has asignificant and negative impact on the price mark-up thathealth centers charge patients for drugs.