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Table 2 The extent of dual practice in several countries

From: Dual practice in the health sector: review of the evidence

Country Type and frequency of dual practice
Angola Dual (public and private) practice is ubiquitous and unregulated [72].
Cambodia Dual (public and private) practice is ubiquitous [89].
Egypt Rural-based Egyptian physicians in private practice are more likely to have a second job (85%) than urban-based physicians (71%). However, there is not much difference between urban and rural physicians in the likelihood of having a third or fourth job: 15% of urban and 11% of rural physicians have a third job and 2% of urban and 1% of rural physicians have a fourth job. Twenty percent of 113 single private practice dentists work only in their private clinic; 73% have 2 jobs, 6% have 3 jobs and 1% have 4 jobs. Among 261 pharmacists 91% have only one job, 8% have two jobs and 1% have 3 jobs. Among 80 other health service providers, mainly unlicensed, who are officially not allowed to operate, but yet provide a significant amount of health care, 66% of the sample have a second job and 1% has a third job [70].
Indonesia Most doctors have dual practices in the public and private sectors [77].
Malawi The government allows serving medical personnel in its facilities to set up private surgeries where they can practice after official duty hours; it further allows those without professional qualifications (e.g. "paramedics") to set up a health care business for minor health complaints [78].
Mozambique Common among urban, but not rural, health professionals [29].
Papua New Guinea Semi-private wards in public facilities are well patronized in the larger hospitals but tend to be underutilised in the smaller provincial centres [79].
Peru Almost all physicians have both public and private practices [77].
Portugal 23% of public sector health centre workers have a second job, the highest rate being for doctors – 43%; 58% of public sector hospital workers have a second job, the highest rate being for doctors – 50% [75, 76,75, 76].
South Africa Half of general practitioners in private practice have other employment. While 36% worked in the public sector, this was more common in rural (62%) compared with urban (21%) areas [80].
Syria Most physicians have dual practice [77].
Thailand An estimate suggested that in Bangkok alone there were over 2000 private clinics, many of these run by government doctors [81]. Private practice by public sector obstetricians is very frequent [55].
Viet Nam Most doctors complement public sector work with private practice [77]. Full-time government employees are supplementing their incomes through part-time private practice. One village-based health survey found that 70% of the drug sellers were moonlighting government workers [82].
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