One out of five Ethiopia doctors take a secondary join in the private sector, while as many doctors leave the public hospitals, according to the book.

The book, titled: “The Labor Market for Health Workers in Africa: A New Look at the Crisis” and jointly edited by Tedros Adhanom Ghebreyesus (Minister of Foreign Affairs and former Minister of Health, Ethiopia), Agnes Soucat (Director of Human Development, AfDB) and Richard Scheffler (professor of Economics, University of California, Berkeley), was officially released last December.

The book indicated that:

“even at an early stage in their career medical professionals adopt dual practice. It found that three years out of college, close to 20 percent of doctors worked exclusively in the private sector and a further 18 percent had a secondary job in a private clinic.

Usually a secondary job in the private sector is work as a clinician in a private facility although there were a few cases of public doctors working in a private (medical) college.

For nurses, secondary practice opportunities are rarer but still possible. The number of medical professionals engaged in dual practice tends to grow as the health workers develop career experience. The main motivation for dual practice in Ethiopia is to increase earnings.”

(See the graph for the proportion of doctors and nurses working in private sector)

However, two out of three of the doctors working in the private sector didn’t obtain official release from the Minister of Health that funded their study.

The book noted that:

“The survey results underline the weakness of the current regulations. While workers whose studies were funded by the government require an official “release” to work in the private sector, the vast majority of doctors active in the private sector (70 percent) did not obtain this release. Complementary qualitative discussions indicated that absenteeism and non-approved private employment are rarely punished.”

Data on the book also indicate high disparity in earning of medical professionals working in Addis Ababa and rural-dominated states. (See the graph; comparing Addis Ababa, Tigray and SNNPR – Southern Nations, Nationalities, and People’s Region)

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