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

Gauthier, Bernard; Wane, Waly

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

Autores

Descripción

In the public sector in developing countries, leakage of public resources could prove detrimental to users and affect the well-being of the population. This paper empirically examines the importance of leakage of government resources in the health sector in Chad, and its effects on the prices of drugs. The analysis uses data collected in Chad as part of a Health Facilities Survey organized by the World Bank in 2004. The survey covered 281 primary health care centers and contained information on the provision of medical material, financial resources, and medicines allocated by the Ministry of Health to the regional administration and primary health centers. Although the regional administration is officially allocated 60 percent of the ministry's non-wage recurrent expenditures, the share of the resources that actually reach the regions is estimated to be only 18 percent. The health centers, which are the frontline providers and the entry point for the population, receive less than 1 percent of the ministry's non-wage recurrent expenditures. Accounting for the endogeneity of the level of competition among health centers, the leakage of government resources has a significant and negative impact on the price mark-up that health centers charge patients for drugs.

Palabras clave

ACCESS TO HEALTH SERVICES, ACCOUNTABILITY, ACCOUNTING, ADULT ILLITERACY, ALLOCATING PUBLIC RESOURCES, ALLOCATION OF RESOURCES, AMBULANCE, BEDS, BENEFICIARIES, BUDGET DOES, BUDGET INFORMATION, BUDGET STRUCTURE, BUDGETARY ALLOCATIONS, BUDGETARY EXPENDITURES, BUDGETARY RESOURCES, CAPITAL EXPENDITURES, CAPITAL INVESTMENTS, CENTRAL BUDGET, CENTRAL GOVERNMENT, CENTRAL GOVERNMENT BUDGET, CHILD MORTALITY, CHILD MORTALITY RATE, CIVIL WAR, CLINICS, CROWDING, DATA COLLECTION, DEATHS, DELIVERY OF HEALTH SERVICES, DELIVERY SYSTEM, DEMAND FOR HEALTH, DEMAND FOR HEALTH CARE, DEMOCRACY, DEVELOPING COUNTRIES, DOCTORS, DRUGS, ECONOMIC POLICY, ECONOMIC REVIEW, ECONOMIES OF SCALE, ELASTICITY OF DEMAND, ELASTICITY OF DEMAND FOR HEALTH CARE, ETHNIC GROUPS, EXPENDITURE LEVEL, EXPENDITURES, EXPENDITURES ON HEALTH, FINANCIAL INFORMATION, FINANCIAL RESOURCES, FINANCIAL SUPPORT, GLOBAL DEVELOPMENT, GOVERNMENT SPENDING, HEALTH ADMINISTRATION, HEALTH CARE CENTERS, HEALTH CARE PROVIDERS, HEALTH CENTERS, HEALTH EXPENDITURE, HEALTH EXPENDITURE PER CAPITA, HEALTH EXPENDITURES, HEALTH FACILITIES, HEALTH IMPACT, HEALTH INDICATORS, HEALTH POLICIES, HEALTH POLICY, HEALTH PROBLEMS, HEALTH PROVIDERS, HEALTH RESOURCES, HEALTH SECTOR, HEALTH SERVICE, HEALTH SERVICE PROVIDERS, HEALTH SERVICE PROVISION, HEALTH SERVICES, HEALTH STATUS, HEALTH SYSTEM, HEALTH SYSTEMS, HEALTH WORKERS, HOSPITAL, HOSPITALS, HUMAN DEVELOPMENT, HUMAN POVERTY, HUMAN RESOURCES, ILLITERACY RATE, IMPACT ON HEALTH, INDIVIDUAL HEALTH, INFECTIOUS DISEASES, INFORMATION SYSTEMS, INTENDED BENEFICIARIES, INVESTMENT BUDGET, LABOR FORCE, LIFE EXPECTANCY, LIFE EXPECTANCY AT BIRTH, LIVE BIRTHS, LOCAL CAPACITY, LOCAL HEALTH CENTERS, MALARIA, MARGINAL EFFECTS, MATERIAL RESOURCES, MEDICAL COSTS, MEDICAL PRODUCTS, MEDICINES, MIDWIVES, MINISTRY OF HEALTH, MISMANAGEMENT, MORTALITY, MOTHER, NATIONAL BUDGET, NATIONAL HEALTH, NATIONAL HEALTH POLICIES, NURSES, OPERATING EXPENDITURES, PATIENT, PATIENTS, PERSONNEL EXPENDITURES, PHARMACIES, PHARMACY, POLICY RESEARCH, POLICY RESEARCH WORKING PAPER, POLITICAL INSTABILITY, POOR PEOPLE, POVERTY REDUCTION, PRICE DATA, PRICE ELASTICITY, PRIMARY CARE, PRIMARY HEALTH CARE, PRIVATE CLINICS, PRIVATE PROVIDERS, PRIVATE SECTOR, PROBABILITY, PROGRESS, PUBLIC ADMINISTRATION, PUBLIC EXPENDITURE, PUBLIC EXPENDITURE SYSTEM, PUBLIC EXPENDITURES, PUBLIC HEALTH, PUBLIC HEALTH CARE, PUBLIC HEALTH EXPENDITURES, PUBLIC HEALTH SPENDING, PUBLIC HEALTH SYSTEMS, PUBLIC MANAGEMENT, PUBLIC RESOURCES, PUBLIC SECTOR, PUBLIC SERVICES, PUBLIC SPENDING, PUBLIC SUPPORT, PUBLIC WORKS, QUANTITATIVE SERVICE DELIVERY, RECURRENT EXPENDITURES, REGIONAL ADMINISTRATION, RESOURCE ALLOCATION, RESOURCE USE, RESPECT, RURAL AREAS, SANITARY FACILITIES, SERVICE ACCESSIBILITY, SERVICE DELIVERY, SERVICE FACILITIES, SERVICE QUALITY, SOCIAL INDICATORS, SOCIAL SCIENCE, SOCIAL SECTORS, SUB-SAHARAN AFRICA, TRANSPORTATION, URBAN AREAS, URBAN CENTERS, USER FEES, VACCINES, WORKERS