Managing Health Services in Developing Countries: Between the Ethics of the Civil Servant and the Need for Moonlighting: Managing and Moonlighting

We report on income generation and work mix among 100 civil servants who manage public health services in developing countries. Their salary puts these managers among the better-off in their countries. However, 87% of the respondents complement their salaries with other income-generating activities. There are three possible consequences: competition for time, outflow of resources from the public sector, and conflicts of interest. The problem of moonlighting needs to be addressed openly so as to protect public sector values while meeting both professional needs and user demands for quality. [adapted from abstract]