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Robert Hecht and PHILIP MUSGROVE

beds are underutilized. Disparities in the average length of stay across hospitals with a similar mix of cases point to major inefficiencies: average stays in government hospitals in Latin America varied from 5 days in Colombia to 13 days in Uruguay. Cost explosion . In some middle-income developing countries, health care expenditures are growing much faster than income, as increasing numbers of specialists, the availability of new medical technologies, and expanding health insurance linked to fee-for-service payments together generate a rapidly growing demand for

K. S. Sundara Rajan

cent effective and, at least for males, has practically no side effects. Sterilizations performed in government hospitals and family planning centers are free; private doctors are also encouraged to carry out the operations and can claim their fees from the government at prescribed rates. Male sterilization is also carried out in mobile vans, and eventually each of the 335 districts will have a sterilization van. That this method has after all reached the rural areas is evidenced by the great increase during last year. Over 862,000 operations were carried out during

International Monetary Fund

were placed in government administration. 3/ Health employment covers employees of government hospitals and health institutions at all levels of government. Wherever possible, administrative employees working in the health sector have been placed in government administration and not in health employment. 4/ Refers to the period 1995-99. 5/ Ratio of average government wage to private sector wage. Refers to the period 1995-99. 6/ Refers to the period 1990-95. 7/ Refers to the period 1995-99. 8/ Measured in thousands of population