Managing dual practice of health workers has often proved to be challenging, especially in emerging countries characterized by weak monitoring and low motivation. This paper exploits an exogenous variation in the initiation of private practice among heads of local public facilities (known as puskesmas) providing primary health care after the introduction of a 1997 health regulation in Indonesia. This regulation required health professionals to apply for a license for private practice at least three years after their graduation.
Exploiting the exogenous variation in private practice after the 1997 regulation, we provide estimates of causal effects of dual practice on provision of public health services, distinguishing between the effects when private practice is located at or away from the public hospital. The estimates suggest that dual practitioners (relative to those engaged in public service only) work significantly less hours per week while they see significantly more patients in their public facilities. These adverse effects of dual practice are most pronounced when private practice is held away from the puskesmas. These results have important bearings on human resource management of universal health care provision.
We use cookies to provide you with an optimal website experience. This includes cookies that are necessary for the operation of the site as well as cookies that are only used for anonymous statistical purposes, for comfort settings or to display personalized content. You can decide for yourself which categories you want to allow. Please note that based on your settings, you may not be able to use all of the site's functions.
Cookie settings
These necessary cookies are required to activate the core functionality of the website. An opt-out from these technologies is not available.
In order to further improve our offer and our website, we collect anonymous data for statistics and analyses. With the help of these cookies we can, for example, determine the number of visitors and the effect of certain pages on our website and optimize our content.