Employers and Patients Evaluation of the Services of Private versus Government Higher Education and Health Delivery Institutions in Addis Ababa

Abstract

As part of the study on Investment Climate and Business Environment (lCBE) in Addis Ababa, Ethiopia, this study reports. on interviews with thirty randomly-selected employers of private higher education (PHE) graduates, thirty of their alumni, and thirty patients of private health institutions. Employers were asked to compare the service provision performance of private higher education graduates and private health service provision with that of government. The comparative criteria for each are listed in tables 2 and 3. In both education and health, with respect to each of the criterion, respondents were asked to choose between About the Same, Better or Worse. About 2/3 of the employers of the PHE graduates stated that the work output of PHE graduates and of government trained graduates was About the Same. 26% rated them Better, and 12% considered them Worse. 45% of the patients said that private sector provision was Better than that of government, while only 11% stated that private provision is Worse. Only 1/3 said that they are About the Same. This implies that compared to education, there is a wider perceived gap in health service provision by government and the private sector in favor of the latter. Under the sum total of health service provision, 82% responded that private provision is Better. From this finding, it can be asserted that private sector higher education and health institutions are making noticeable progress at least in the eyes of employers of graduates and patients receiving the services of private health institutions. The policy reforms appear to be bearing fruit, as expressed in the expansion figures for PHE and private health service provisions reported in the main study. However, there are several areas that require fine tuning of policy and institutional reforms. Rather than absorbing the "leftover" from the government sector, as is the case now, genuine and effective partnerships between government and private institutions, need to be remodeled with a certain level of autonomy for each. Government needs autonomy to ensure that its social goals are not subsumed by the profit motive of private firms. The latter requires autonomy to tailor its services in order to meet the specific demands of the market. As the ultimate beneficiaries of the process, employers, students and patients can enrich the institutional development package.