... underestimation of the phenom-enon of informal payments.Furthermore, the need to divide by cadres and ensure the continuance of the activity in the clinics limited the number of health workers involved in ... practisedual jobs in the majority of cases; they often use their pub-lic job to maintain their reputation and recruit theirpatients for their private clinics. However, the practice of shifting patients ... policy[10,16,17]. Finally, the informal nature of unofficial pay-ments undermines governments' ability to raise financesfor health [1,2] and to regulate the financing of health care.On the other hand,...