Abstract: 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.

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.

This publication presents tools and techniques for measuring service delivery in health and education and people's experiences from the field in deploying these methods. It begins by providing an introduction to the different methodological tools available for evaluating the performance of the health and education sectors. Country specific experiences are then explored to highlight lessons on the challenges, advantages and disadvantages of using different techniques to measure quality in a variety of different contexts and of using the resulting data to affect change. This book is a valuable resource for those who seek to enhance capacity for the effective measurement of service delivery in order to improve accountability and governance and enhance the quality of service delivery in developing countries.

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.

This volume analyzes the corruption phenomenon in Africa and how to combat it from a governance perspective with illustrated case studies from three of the most corrupt of those nations covering, respectively, the Southern Africa region (Swaziland); the Eastern Africa region (Kenya); and the Western Africa region (Nigeria). Drawing on the available data, research literature, and field practice experience, the nature and extent of corruption are identified; the factors influencing the causes and determining the consequences of corruption are delineated; measures that have been put in place to control corruption are outlined and discussed; and new policy solutions are proposed and advocated to more effectively control the corruption menace in Africa.

Abstract: This paper investigates individuals' bypassing behavior in the health sector in Chad and the determinants of individuals' facility choice. The authors introduce a new way to measure bypassing using the patients' own knowledge of alternative health providers available to them instead of assuming that information as previously done. The authors analyze how perceived health care quality and prices impact patients' bypassing decisions. The analysis uses data from a Quantitative Service Delivery Survey in Chad's health sector carried out in 2004. The survey covers 281 primary health care centers and 1,801 patients. The matching of facility data and patient data allows the analysis to control for a wide range of important patient and facility characteristics, such as income, severity of illness, quality of health care, or price of services. The findings show that income inequalities translate into health service inequalities. There is evidence of two distinct types of bypassing activities in Chad: (1) patients from low-income households bypass high-quality facilities they cannot afford to go to low-quality facilities, and (2) rich individuals bypass low-quality facilities and aim for more expensive facilities that also offer a higher quality of care. These significant differences in patients' facility choices are observed across income groups as well as between rural and urban areas.

Despite its vast oil wealth, central Africa still struggles to sustain strong, inclusive economic growth and to generate sufficient employment opportunities, particularly for its fast-growing youth population. Drawing on new research, Oil Wealth in Central Africa lays out the macroeconomic and growth challenges facing the region; examines oil wealth management and its implications for poverty reduction; and includes four case studies that exemplify lessons learned.

For over eighty years the Arab region has been deriving massive wealth from its natural resources. Nevertheless, its economic performance has been at the mercy of ebbs and flows of oil prices and its resources have been slowly depleting. The two critical questions are why and how Arab countries might escape the oil curse. Institutions and Macroeconomic Policies in Resource-Rich Arab Economies focuses on the unique features of the Arab world to explain the disappointing outcomes of macroeconomic policy. It explores the interaction between oil and institutions to draw policy recommendations on how Arab countries can best exploit their oil revenues to avoid the resource curse. Case studies and contributions from experts provide an understanding of macroeconomic institutions (including their underlying rules, procedures and institutional arrangements) in oil-rich Arab economies and of their political economy environment, which has largely been overlooked in previous research. Institutions and Macroeconomic Policies in Resource-Rich Arab Economies offers novel macroeconomic policy propositions for exchange rate regimes, fiscal policy and oil wealth distribution that is more consistent with macroeconomic stability and fiscal sustainability. These policy reforms, if implemented successfully, could go a long way in helping the resource-rich countries of the Arab region and elsewhere to avoid the oil curse.