Informal Payments and Moonlighting in Tajikistan's Health Sector

Dabalen, Andrew ; Wane, Waly

World Bank, Washington, DC

关键词: ABUSE;    ACCESS TO HEALTH CARE;    ACCESSIBILITY;    ACCESSIBILITY OF CARE;    AGGRESSIVE;   

DOI  :  10.1596/1813-9450-4555
RP-ID  :  WPS4555

学科分类：社会科学、人文和艺术（综合）

来源: World Bank Open Knowledge Repository

【 摘 要 】

This paper studies the relationshipbetween gender and corruption in the health sector. It usesdata collected directly from health workers, during a recentpublic expenditure tracking survey in Tajikistan'shealth sector. Using informal payments as an indicator ofcorruption, women seem at first significantly less corruptthan men as consistently suggested by the literature.However, once power conferred by position is controlled for,women appear in fact equally likely to take advantage ofcorruption opportunities as men. Female-headed facilitiesalso are not less likely to experience informal chargingthan facilities managed by men. However, women aresignificantly less aggressive in the amount they extractfrom patients. The paper provides evidence that workers aremore likely to engage in informal charging the farther theyfall short of their perceived fair-wage, adding weight tothe fair wage-corruption hypothesis. Finally, there is someevidence that health workers who feel that health careshould be provided for a fee are more likely to informallycharge patients. Contrary to informal charging, moonlightingbehavior displays strong gender differences. Women aresignificantly less likely to work outside the facility onaverage and across types of health workers.