In this paper, we report results from surveys in which enumerators made unannounced visits to primary schools and health clinics in Bangladesh, Ecuador, India, Indonesia, Peru and Uganda and recorded whether they found teachers and health workers in the facilities. Averaging across the countries, about 19 percent of teachers and 35 percent of health workers were absent. The survey focused on whether providers were present in their facilities, but since many providers who were at their facilities were not working, even these figures may present too favorable a picture. For example, in India, one-quarter of government primary school teachers were absent from school, but only about one-half of the teachers were actually teaching when enumerators arrived at the schools. We will provide background on education and health care systems in developing; analyze the high absence rates across sectors and countries; investigate the correlates, efficiency, and political economy of teacher and health worker absence; and consider implications for policy.
Twenty‐five percent of teachers were absent from school, and only about half were teaching, during unannounced visits to a nationally representative sample of government primary schools in India. Absence rates varied from 15% in Maharashtra to 42% in Jharkhand, with higher rates concentrated in the poorer states. We do not find that higher pay is associated with lower absence. Older teachers, more educated teachers, and head teachers are all paid more but are also more frequently absent; contract teachers are paid much less than regular teachers but have similar absence rates; and although relative teacher salaries are higher in poorer states, absence rates are also higher. Teacher absence is more correlated with daily incentives to attend work: teachers are less likely to be absent at schools that have been inspected recently, that have better infrastructure, and that are closer to a paved road. We find little evidence that attempting to strengthen local community ties will reduce absence. Teachers from the local area have similar absence rates as teachers from outside the community. Locally controlled nonformal schools have slightly higher absence rates than schools run by the state government. The existence of a PTA is not correlated with lower absence. Private‐school teachers are only slightly less likely to be absent than public‐school teachers in general, but are 8 percentage points less likely to be absent than public‐school teachers in the same village. (JEL: O15, I21, H41, H52)
Chaudhury and Hammer report on a study in which When separated into level of facility, the absentee rate unannounced visits were made to health clinics in for doctors at the larger clinics is 40 percent, but at the Bangladesh with the intention of discovering what smaller subcenters with a single doctor, the rate is 74 fraction of medical professionals were present at their percent. assigned post. This survey represents the first attempt to Even though the primary purpose of this survey is to quantify the extent of the problem on a nationally document the extent of the problem among medical representative scale.staff, the authors also explore the determinants of staff Nationwide the average number of vacancies over all absenteeism. Whether the medical provider lives near the types of providers in rural health centers is 26 percent.health facility, access to a road, and rural electrification Regionally, vacancy rates (unfilled posts) are generally are important determinants of the rate and pattern of higher in the poorer parts of the country. Absentee rates staff absentee rates. at over 40 percent are particularly high for doctors.
Unannounced visits were made to health clinics in Bangladesh to determine what proportion of medical professionals were at their assigned post. Averaged over all job categories and types of facility, the absentee rate was 35 percent. The absentee rate for physicians was 40 percent at the larger clinics and 74 percent at the smaller subcenters with a single physician. Whether the medical provider lives near the health facility, the opportunity cost of the provider's time, road access, and rural electrification are highly correlated with the rate and pattern of absenteeism.
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