Informal Payments and the Financing of Health Care in Developing and Transition Countries

Abstract

Informal, under-the-table, payments to public health providers are increasingly being seen as a critically important source of health financing in developing and transition countries. With minimal funding levels and limited accountability publicly financed and delivered care falls prey to illegal payments, which require payments that can exceed 100 percent of median income. Methods to address the abuse include establishing official fees combined with improved oversight and accountability for public health providers, and a role for communities in holding providers accountable.