U4 ISSUE

December 2012 No 8

Per diem policy analysis toolkit

Taryn Vian
Lora Sabin

Anti-
Corruption
Resource
Centre
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U4. (Copyright 2012 - CMI/U4)
Per diem policy analysis toolkit

Taryn Vian
Lora Sabin

U4 Issue
December 2012 No 8
Contents

1. Introduction .......................................................................................................................................... 1
2. Background ........................................................................................................................................... 3
2.1 Purpose and characteristics of per diems ............................................................................................. 3
2.2 Overview of main types of abuse .......................................................................................................... 4
2.3 Overview of mitigating strategies.......................................................................................................... 5
3. Overview of the toolkit ......................................................................................................................... 7
4. Tools for per diem policy and management analysis .............................................................................. 8
4.1 Tool 1. Types of per diem allowances ................................................................................................... 8
4.1.1 Categories of allowances................................................................................................................... 8
4.1.2 Levels of staff .................................................................................................................................. 11
4.1.3 Other Categories ............................................................................................................................. 12
4.1.4 Tips for data collection .................................................................................................................... 12
4.1.5 Interpreting and using the data ...................................................................................................... 13
4.2 Tool 2. Policy characteristics and control systems .............................................................................. 13
4.2.1 Policy characteristics ....................................................................................................................... 13
4.2.2 Control systems and procedures..................................................................................................... 16
4.2.3 Contextual factors ........................................................................................................................... 18
4.2.4 Tips on collecting this information .................................................................................................. 19
4.3 Tool 3. Per diem spending ................................................................................................................... 20
4.3.1 Indicators......................................................................................................................................... 20
4.3.2 Data Needed ................................................................................................................................... 21
4.4 Calculating Indicators .......................................................................................................................... 21
4.5 Tool 4. Survey on attitudes and practices ........................................................................................... 22
4.5.1 Survey components ......................................................................................................................... 22
4.6 Tool 5: Planning for dissemination ...................................................................................................... 25
4.6.1 Research report ............................................................................................................................... 25
4.6.2 Policy brief ....................................................................................................................................... 26
4.6.3 Press release and social media........................................................................................................ 26
4.6.4 Dissemination tools: presentations, town meetings....................................................................... 26
4.7 Tool 6: Further reading and resources ................................................................................................ 27
Annex I: Sample table of indicators of per diem spending ............................................................................ 28
Annex II: Survey on attitudes and practices.................................................................................................. 29

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Abstract
Most organizations use per diems as a way to reimburse out-of-pocket expenses for travel and to
encourage staff to attend professional development activities. However, weaknesses in policy design
and control of spending can cause problems, including distortions of human resource systems, fraud
and abuse by staff. Governments and non-governmental organizations need to adopt and implement
fair, transparent, and efficient policies which provide adequate compensation for work-related travel
without creating adverse incentives. This toolkit proposes a methodology to study per diem policies of
the health sector in a given country, in government, international, or non-governmental organizations.
It presents tools designed to describe and analyse the different types of per diems, policy
characteristics and control systems, per diem spending, and attitudes and perceptions of staff as a
means for identifying corruption risks. Our goal is to help governments and collaborating development
partners assess their specific problems, and begin to develop solutions. While the toolkit was designed
for the health sector, it can also be applied to other sectors with little adaptation.

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1. Introduction
Per diem is defined as “daily subsistence allowance intended to compensate employees of public and
private organisations for extra expenses incurred when on work-related assignments or travel away
from their normal duty station or home base” (Søreide, Tostensen, & Skage, 2012). Per diem rates are
determined prospectively and payable according to set rules. Most organizations use per diems as a
way to reimburse out-of-pocket expenses for meals, lodging, and incidentals, and to encourage staff to
engage in professional development activities such as conferences and trainings.

In low-income settings, per diems are an increasingly important source of compensation for many
workers (Chêne, 2009; Roenen, Ferrinho, Van Dormael, Conceicao, & Van Lerberghe, 1997). This
may be due in part to difficulties in implementing structural reforms of pay systems. For example,
policy makers may be reluctant to increase public salaries if they are uncertain that future revenues can
maintain this level of spending. Instead, it may seem safer to supplement salaries with allowances such
as per diems, which can easily be cut back if economic times get tough. A main concern with per diem
spending is that per diem policies are often manipulated and abused by individuals to increase their
compensation, or per diem-related decisions are made in ways that appear to favour some staff over
others (Vian, Miller, Themba, & Bukuluki, 2012). Per diems and other allowances have been shown to
distort human resource management systems by shifting the focus of work from routine tasks to
workshop attendance and to tasks within specific programs for which per diems are available (Hanson,
2012). Higher level employees may even seek to maximize personal income by adding unnecessary
workshops and travel to budgets, or by creating fake records of travel to defraud the system. These
types of “gaming” the system and rent seeking behaviour are seen as inflating the cost of services
(Policy Forum, 2009; Søreide et al., 2012).

We want to encourage the adoption and implementation of fair, transparent, and efficient policies
which provide adequate compensation for truly work-related travel without creating adverse incentives
and other distorting effects. This toolkit proposes a methodology to study per diem policies of the
health sector in a given country, in government, international, or non-governmental organizations.
Survey forms, interview guides, indicators, and suggested sources of data are some of the tools you
will find here. These tools can be applied to help gather more data so that interested stakeholders can
be better informed as they work together to improve policies. While the toolkit was designed for the
health sector, in fact it could be applied to other sectors in a country with little adaptation. We
encourage users of the toolkit to write to U4 tell us how it was used and whether the analysis had an
impact. If possible, update may be issued based on any feedback received.1

The toolkit is informed by a review of the literature on per diem policies, including two recent studies
in particular. The first is a set of country studies examining the origins and consequences of per diem
compensation conducted by Chr. Michelsen Institute (CMI) researchers in Tanzania, Ethiopia, and
Malawi (Søreide et al., 2012). This study examined per diems through the broad lens of political
economy analysis, looking at government institutions, power relationships, and stakeholders. The
second source is a study of health staff perceptions of per diem abuse in Malawi and Uganda by the
Boston University School of Public Health researchers, with support from the U4 Anti-Corruption
Resource Centre (Vian, Miller, Themba, & Bukuluki, 2011; Vian et al., 2012). This study applied
qualitative research methods to understand individual perspectives and organizational issues related to
per diem abuses. We also draw on our professional experience working as advisors with governments,
non-governmental organizations (NGOs), and donors on health policy and management in Africa and
Asia.

1 Write to [email protected]

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The report is organized as follows. Section 2 provides background information on per diem policies,
the risks for abuse and corruption and mitigating strategies. This section draws on key references listed
at the end of the toolkit. Section 4 provides an overview of the toolkit, including a short description of
each tool and its purpose. Finally, Section 4 presents the tools themselves.

As each tool is discussed, we suggest ways in which the data may be interpreted, and how each type of
data helps to inform stakeholders about areas of risk and possible consequences of current per diem
policies. We try to relate the data to reform directions and options. However, the toolkit is not meant to
be prescriptive. Our goal is to provide tools through which governments and collaborating
development partners can assess and evaluate their specific problems and issues, and begin to develop
and own their solutions.

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2. Background
2.1 Purpose and characteristics of per diems
Per diem policies in organizations serve two main purposes: to fund expenses which employees may
incur for approved, work-related activities; and to encourage professional development through
attendance at workshops, conferences and other training or staff development events. In addition, per
diems are sometimes used informally to incentivize employees and increase job satisfaction, without
having to permanently increase salaries (Vian 2009).

Reimbursing employees for work-related expenses has advantages and disadvantages. A U4 study
which gathered data from 41 key staff in government and NGO organizations in Malawi and Uganda
found that staff liked per diems because they facilitated getting work done, encouraged training which
increased the knowledge base of organizations, and motivated staff to be more productive (Vian et al.,
2012). Employees also perceived that per diems benefited them personally by providing additional
revenue to pay household expenses and save for the future. At the same time, the U4 study identified
disadvantages of per diems: informants expressed concern that per diems create conflict among staff
and contribute to a negative culture where people expect to be paid for all work activities. Per diems
also lead to changes in how work time is allocated in order to maximize time spent in per diem-
earning activities. Some informants worried about the sustainability of health program strategies which
rely on per diem spending, and complained that where policies are not implemented fairly, some
employees benefit more than others (Vian et al., 2012).

Some government policies distinguish between two types of allowances based on whether they are
remunerative or discretionary (Rubin, 2012; Søreide et al., 2012). Remunerative allowances are linked
to a specific position, for example uniform allowance or housing allowance. Discretionary allowances,
also called duty-enhancing allowances, are linked to specific duties such as traveling or attending a
workshop outside of one’s duty station. The discretionary allowances require managerial approval
before the travel is permitted, and permission is dependent on the need for the travel, organizational
priorities, and the operational plan and budget. The distinction between remunerative and discretionary
allowances, while helpful in theory, is often blurred in practice and discretionary allowances can also
be remunerative. For example, per diems in Ethiopia were perceived as a way to top up salaries and
create extra benefits for employees (Søreide et al., 2012).

Per diem rates are established in advance to reduce the administrative burden of having to report on
and reimburse actual expenses. This practice of standard rates provides an incentive for employees to
minimize actual expenses, as they get to keep the difference between actual expenses and the standard
per diem rate.

In some countries (e.g. Malawi and Tanzania) per diem rates are very high in relation to wages, while
in others (Ethiopia), per diem rates are low in relation to average wages. Per diem spending in relation
to total government budget may also vary (from 1.6% in Tanzania to 6% in Malawi) and in relation to
total spending on wages and allowances (16.2% in Tanzania and 22% in Malawi) (Søreide et al.,
2012).

Researchers have calculated several indicators which can be used to assess fairness or unfairness in the
distribution of per diem spending, including the ratio between per diem rates earned by central versus
local government employees (3:1 in Tanzania), and the ratio between rates earned by the highest paid
versus the lowest paid employee (4:1 in Tanzania) (Søreide et al., 2012). Per diem rates that were four
times greater for high-level employees those paid to the lowest-level employees was seen as unfair,
given that the stated purpose of per diems was to reimburse travel expenses and not to remunerate
staff. The researchers argued that there should be no distinction between per diem rates for employees
of different ranks (Søreide et al., 2012). While a country may decide it prefers to vary per diem rates

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by location or cadre of employee, it is still important to compare the stated policy with empirical data,
and to discuss the implications of such a policy. We have incorporated some of these indicators into
our tool for assessing spending on per diems (Tool 3).

2.2 Overview of main types of abuse

Experts have identified many ways in which people can abuse per diems, as shown in Figure 1.
Motivated by the desire to maximize opportunities to earn per diem and to increase the days and
amounts gained, employees may distort work plans and strategies, conduct unnecessary field trips or
attend training they do not need, or even commit fraud. The impact of these practices is excessive
travel, budget losses, and corruption which increase costs and prevent organizations from reaching
service goals in a timely way (Jack, 2009). Chronic abuse of per diems also results in decreased
intrinsic motivation, where people seek to be paid for every task, and begins to change organizational
culture so that these practices are tolerated and accepted (Grepin, 2009; Ridde, 2010; Vian, 2009).

Table 1
Motivation Mechanism Abuses

Increase Favoritism and Patronage • Giving opportunities to earn per diem to favoured
opportunities Planning and Budgeting employees, friends, and kin
to earn per System
diem • Influencing plans and budgets to increase the use of per
diem-friendly strategies such as travel and training
• Planning meetings or activities in locations that require
travel and per diem
• Seeking out ways to attend trainings which are not
necessary for one’s work
• Attending multiple workshops in one day, without
staying for all of the sessions

Maximize Planning and Budgeting • Over-estimating days needed for tasks which earn per
days of per System diem
diem earned Program Implementation • Splitting trips or creating extra trips
Financial System
• Claiming per diem days which were budgeted, even if
work is postponed or takes less time than planned
• Handling per diem meant for another employee, and
keeping some or all of it for oneself (e.g. driver’s per
diem)
• Accepting payment from two or more sources for the
same activity or travel

Divert budget Financial System • Using fake attendance lists or other documentation to
for per diems justify spending which is really embezzled
• Requiring kickbacks from staff who earn per diems

Vian, et al. (2012, 2011) documented ways in which policies are manipulated to maximize financial
gain, including by slowing work, scheduling unnecessary trainings, and exaggerating time needed for
certain tasks. Other types of abuse included receiving per diem from two sources for the same activity
(double-pay), falsifying participant lists at training, taking per diems meant for other staff, and not
refunding per diem which was not fully spent.

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Søreide, et al. (2012) assessed the impact of per diem systems on development programmes, national
budgets, and employee incentives. The researchers noted common types of abuses including double-
dipping, organizing workshops in an opportunistic manner, using opportunities to earn duty
allowances as a way to buy loyalty, and general tolerance of corruption. We have used this
information to develop questions on attitudes for the survey tool (Tool 4).

Context is critical to understanding the nature of problems with per diems (i.e. the type and scope of
abuse, waste or inequalities), and roots of the problem and possible solutions. Important contextual
factors include salary rates, aid dependence, inflation, and whether allowances are considered taxable
income, as described below:

• Salaries. Low salaries can be a driver or motivator for people to abuse per diems. In countries
like the U.S., where daily salary rates are higher than per diem payments, the small amounts
that can be earned by manipulating per diems may not provide adequate incentive to engage in
abuse (although some abuses do occur). However, in countries where the per diem rate may be
2 to 9 times the average daily salary, low salary is more likely to be a motivating factor for
abuse. Some experts suggest that low wages may be used as an excuse to defend abuse.2
• Aid dependence. Countries such as Tanzania, where one-third of the recurrent budget is
funded by contributions from over 40 donors, or Ethiopia with 50 donors, face particular
challenges aligning donor and government per diem policies (Søreide, Tostensen et al. 2012;
Rubin 2012). In a very aid dependent country, there could be more intense competition among
donors to get government officials to attend their meetings and trainings, which can drive up
per diem rates.
• Inflation. Inflation is an important contextual factor in countries such as Ethiopia, where per
diem rates have not kept up with the rising cost of accommodation and meals. In this context,
abusive practices such as exaggerating days of travel (claiming 10 days when only 5 were
actually spent in the field) may appear to be justified, since the per diem rates are too low to
cover true costs. This could erode rule-following behaviour in general.
• Taxation. In many countries, per diem income from both donors and government is not taxed,
which makes it more attractive and therefore vulnerable to abuse (Søreide, Tostensen et al.
2012).

2.3 Overview of mitigating strategies

Strategies to reduce abuse of per diems focus on increasing controls and enforcement, while also
decreasing opportunities and pressures to abuse per diems. Mitigating strategies must be considered in
light of existing institutions and power relationships, i.e. a full understanding of the political economy.
Some strategies would be possible to apply within the health sector alone, while others would be
whole-of-government approaches. Strategies to consider include:

• Reducing pressures: Moving some part of current allowance spending to salary support;
standardizing rates (among different organizations); changing timing of payment (not giving
all the per diem allowance in advance); or pre-paying accommodation.
• Controlling discretion: Eliminating discretionary allowances (adding a pre-determined
amount to salaries instead); requiring recipient signatures; separating tasks of budgeting for
and spending allowances; increasing supervision and audit functions; developing online
payment systems. At the macro level, it is important to introduce or enhance existing checks
and balances in institutions, for example through capacity strengthening of an independent
national audit office.

2 Tina Søreide, personal communication, October 7, 2012.

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• Increasing transparency: Making sure that staff are informed of policies; disseminating
information about planned and actual spending on allowances, and on work plans.
Transparency strategies should try to increase the ability of people at lower levels of the
system to “see” how decisions are being made at higher levels, and should allow people
outside the organization to see inside. Transparency in rates could be improved by having just
one rate for all cadres of worker, as some experts have recommended.
• Increasing accountability: Creating performance indicators (e.g. average spending on per
diem per employee); requiring back to office reports or training reports. Accountability is also
enhanced by support given to assure a free press which is able to investigate and reveal abuses
or risks for abuse.
• Strengthening detection and enforcement: Creating complaint mechanisms; strengthening
systems for tracking abusers and types of abuses; reducing barriers to punishing employees for
abuse. As mentioned earlier, strengthening of an independent national audit office can provide
checks and balances, helping to deter abuses within the health sector.
• Developing leaders: Designing selection and promotion criteria and procedures to encourage
moral leadership. Providing recognition to leaders and managers who reduce abuses and
address complaints effectively.

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3. Overview of the toolkit

This toolkit provides templates and instructions to enable donors, health sector experts, and NGOs to
document current spending on per diems, policies guiding per diem administration, and attitudes and
practices related to per diem manipulation and abuse. We also include guidance for data collection and
analysis. Together, the tools are intended to identify how the current policies may be vulnerable to
abuse. This information can serve as a guide for designing context-specific remedial strategies aimed
at improving transparency, perceived fairness, detection of abuse, and appropriate sanctions. The main
areas covered include:

Types of per diem allowances

This tool provides guidance on how to categorize and summarize different types of per diem
allowances. This helps facilitate comparisons across agencies/NGOs and regional areas/countries.

Policy characteristics and control systems

The second tool provides guidance on how to describe and analyse per diem policies and control
systems. Key characteristics of policies are identified, including the rate-setting process, rate variation,
what per diems should cover, how advances are handled, control procedures, and roles of different
institutions. We also suggest contextual information that may help illuminate the policy process and
drivers of current practices related to manipulation or abuse.

Per diem spending

The third tool includes indicators and guidance for budget analysis to determine and compare levels of
spending on per diems. Although data required for ratios (i.e. total wages, per capita GDP, etc.) are
time and country specific, we have provided suggestions for how to find the figures.

Survey on attitudes and practices as a means for corruption risk identification

The fourth tool is a survey instrument to illustrate how to conduct a sample survey of workers to
assess attitudes and practices related to per diems. Including both quantitative and qualitative
questions, this survey measures knowledge of and satisfaction with current policies, perception of risk,
and experience with per diems. It also attempts to gather data on per diem income compared to salary.
These data may be used to set priorities for how to deal with risks of abuse, and to determine a
baseline against which to measure reforms.

Guidance for dissemination and policy dialogue

The first four tools deal with data collection and analysis. This fifth tool provides suggestions for ways
to develop reform strategies grounded in evidence in a particular country context, and to assure
reforms address the roles and contributions of NGOs and development partners as well as government
institutions.

Further reading and resources

The last tool provides a list of published and unpublished sources for further information on per diem
policy research.

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4. Tools for per diem policy and management analysis

4.1 Tool 1. Types of per diem allowances
Policy analysis related to per diem management requires consistent use of terminology and
comprehensive information. This tool reviews the different types of per diems and suggests ways to
categorize them. The information can be used to collect data on per diem policy details and procedures
(Tool 2) and to summarize spending on per diems (Tool 3).

Per diem is a type of daily allowance which may be paid to employees who take part in work-related
activities outside of their duty station, such as travel to attend meetings, engage in supervision, or
participate in training. The per diem is meant to compensate employees for the extra expenses incurred
while undertaking these work-related activities.

Per diem rates are generally set in advance. This is because it would require a lot of time and effort to
document, review, and account for actual expenditures of the many employees who incur work-related
expenses during travel. Instead, many organizations develop daily allowance rates, determined
prospectively, to cover subsistence costs such as lodging, meals and incidentals. In theory, the daily
per diem rate should be set slightly above the expected average cost for a day of travel, to make sure
that actual expenses are covered.

Søreide, Tostensen and Skage (2012) distinguish between remunerative allowances, and “duty-
enhancing” allowances. Remunerative allowances are an entitlement of employment contract, often
used to make a post more attractive (e.g. housing allowance, hardship post allowance). Duty-
enhancing allowances are distinguished by the fact that the allowance is not an entitlement of
employment, but depends on the discretion of the manager (e.g. per diem, night differential paid to
hospital staff who work night shifts). While the manager must respect the duty-enhancing allowance
rate established by organizational policy, it is up to the manager to approve work-related activities by
which the employee can earn the allowance. Regarding per diem, it is the manager who decides which
staff can travel and for how long. Management discretion is an important part of the risk of abuse
inherent in allowances.

Below is a list of common types of allowances. This tool is useful for researchers to gain an overview
of which organizations provide which types of allowances, and how they define them. Not all
countries or organizations will have all types of allowances. Different terms may be used, so it is
important to understand how allowances are labelled in the organization being studied.

Our focus is on daily allowances which are related to travel, meetings, and workshops, including per
diem and transportation. These allowances are often given more frequently and may be more
vulnerable to abuse. The other types of allowances are included to provide a comprehensive list. Later
in the toolkit we will discuss how to evaluate the magnitude of per diem spending in comparison with
other employment allowances. This list might be helpful in reviewing budget figures to establish the
total spending on allowances.

4.1.1 Categories of allowances

The list below was developed using the model of allowances from the Government of Uganda, with
modifications to include other possible headings and alternative categorizations.

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Per diem, also called “night allowance,” “daily subsistence allowance,” or “field
allowance”

This is the amount paid for travel outside one’s duty station which involves an overnight stay. Reasons
for travel may include attending a workshop or conference, or conducting supervision. This is
typically meant to be a duty-enhancing allowance.

• The rate may be divided by type of expenditure, the most common of which are
accommodation, meals, and incidentals (i.e. personal phone calls, laundry, newspaper, tips,
etc.). Work-related travel and work-related telephone calls are often reimbursed separately
from per diem.
• If accommodation or meals are pre-paid, a percentage may be deducted from the per diem
rate. This is sometimes the case with workshops or travel to large urban areas, where the
organization may be able to arrange billing with a preferred hotel.
• In some situations, an organization may be allowed to pay per diem to individuals attending a
workshop or meeting within duty station. The per diem policy should be reviewed to
determine if this is allowed.

Safari day allowance (SDA)

This is the amount paid for travel when an employee travels on duty and returns to duty station the
same day. This is typically meant to be a duty-enhancing allowance.

• Minimum duration of travel may be specified (i.e. at least 6 hours)

Sitting allowance

This refers to the amount paid for a public or non-public officer who is appointed to “sit” on a
commission, committee, or interviewing panel. It is usually given per meeting. It is meant to be a duty-
enhancing allowance. There may be alternative applications of this allowance; for example, in some
countries, this term may be used to refer to per diems paid for any employee attending a meeting or a
workshop.

Lunch or dinner allowance

This is the amount paid for work during lunch time or dinner time, whether within or outside duty
station. For example, the government of Uganda pays a lunch and dinner allowance to nurses who are
required to be at their post during dinner time. If a Ugandan worker already is receiving SDA for
travel, she or he is not entitled to lunch or dinner allowance. It is meant to be a duty-enhancing
allowance.

• Usually approved in advance. This is provided to staff who are required to work through their
lunch/dinner hour.

Transportation reimbursement

This is typically paid to staff to reimburse expenses incurred (e.g. fuel, bus) for work-related travel. It
is included as an allowance because it is sometimes paid as a fixed sum based on the average estimate
of travel expenses, although it may also be reimbursed based on actual receipts. It is not intended to
cover the expense of going from home to office (see Transport Allowance, under Other category).

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Other allowances

Depending on the country or organization, there may be other allowance categories, such as those
below. Not all organizations will use all categories, and some organizations may have other categories
for allowances.

• Honoraria: This is an amount paid to staff assigned work of great importance to government
and involving added responsibilities. For example, the Government of Uganda allows the
payment of honoraria to government staff who are assigned work outside the normal scope of
the Officer’s duties, involving a disproportionate amount of official and private time,
additional responsibilities, and “direct use of the officer’s special talent or professional skill”.
The honoraria is based on days worked and is a proportion of salary. It is payable only on
completion of the work product. Honoraria may be accounted for as a salary expense (with the
detail in the payroll system), or as an allowance.
• Overtime (also called “locum”): Overtime is paid to compensate clinical staff who work
extra hours, often to cover for shortages of staff. Similar to honoraria, overtime may be
recorded as salary expense, or as a separate allowance line item.
• Transport allowance: This allowance is a set amount paid to officers to cover the expense of
10ravelling from home to office. Not all employees will be entitled to transport allowance.
Where this allowance is provided, it is a remunerative allowance. It is separate from
transportation reimbursement for special travel to attend off-site work-related activities,
considered earlier.
• Training or facilitation allowance: Training allowances include a professional fee paid to an
employee for presenting paper or for acting as an external examiner or grader, a fee paid to a
part-time lecturer, or an amount given to pay for books required for an approved educational
activity. In some countries the allowance category “Honoraria” may include training or
facilitation allowances.
• Other allowances may include air time for cell phones; hardship pay; expenses of funerals,
housing, medical care, outbreak response work, security, and coverage of a range of costs
associated with assignment overseas or to another post, such as relocation/baggage, transit (for
time in airports in transit), warm clothing, and children’s school fees. These allowances are
generally not daily allowances, and many are exceptional or not common (e.g. warm clothing
allowance). We do not present tools to specifically analyse these per diems, but recommend
that you try to determine if the organization has them, and whether anyone is concerned about
abusive practices related to them.

For the analysis of per diem spending (Tool 3), we are generally interested only in categories 1-2, i.e.
daily subsistence allowance (per diems) and safari day allowances. However, depending on the setting,
other types of allowances may be subject to abuse and therefore worth tracking, for example, sitting
fees. Table 1.1 below can help organize information as you try to distinguish the types of per diem-
related duty-enhancing daily subsistence allowances in your area or organization.

Table 2 considers whether or not the allowance is included in the personnel (salaries and wages) major
line item heading of the budget. Some allowances might not be considered a personnel expense. For
example, per diem for a workshop might be considered under a “Training” line item, and
transportation allowance might be considered under a “Travel” line item. We will come back to this
information later in the toolkit, when we calculate indicators of per diem spending.

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Table 2: Worksheet to record alternative names for daily subsistence allowances, and how they
appear in budgeting and accounting systems

Per diem (daily Safari allowance (daily Other duty-enhancing

subsistence subsistence allowance daily subsistence
allowance for without overnight) allowance
overnight)

Alternative name(s) used (e.g. (write name here) (write name here) (write name here)
“night allowance”)

Included in Personnel line item Yes No Yes No Yes No

heading? (circle response)

If not included in Personnel line

item, specify line item where this
expense appears in budget (e.g.
travel & transport, training, etc.)

4.1.2 Levels of staff

In the public sector, per diem rates are often distinguished by salary level or cadre. Generally, higher
level personnel are entitled to higher per diem rates. Salary structures can be complicated and very
detailed. For example, Uganda has 5 salary schedules (e.g. political leaders, non-political leaders,
primary school teachers, medical workers, and legal professionals), 16 salary scales (e.g. U1, U1S,
U1SE, U2, etc.), and 100 salary designations (e.g. Minister of State, Senior Medical Officer, Entry
level Teacher, Entry Medical Worker, etc.) for payroll. In Malawi, daily subsistence allowance rates
are set for seven different levels of salary grades (Søreide, et al. 2012; 45).

It is helpful to analyse how per diems vary by level of staff, and in comparison with salaries. Too
much detail can complicate the analysis, so it is helpful to create levels for comparison. It is a good
idea to retain detail on how the levels were created, for future reference. Be sure to clearly indicate
where key health personnel fit in the staff levels. For example, in a comparison of per diem rates and
salary information in Uganda, researchers created the five categories of staff shown below. The
original mapping also included the specific civil service salary scale identification numbers, which
would help Ugandan policy makers interpret and use these staff categories.

1) Political Leaders (includes Prime Minister, Presidential Advisors, Ministers

2) Permanent Secretary level (includes Permanent Secretary, Head of Public Service, Director,
Commissioner, Deputy Commissioner)
3) High-level Officers (Principal Medical Officer, Senior Medical Officer)

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4) Mid-level Officers (Nurses, Laboratory Technicians, Teachers, Police constable)

5) Low-level Staff (Nurse Assistants, Drivers, Non-formal Education Teacher)

4.1.3 Other categories

Per diem data also may vary by location or area of the country; for example, in Tanzania, higher rates
are allowed for government travel to cities, medium-level rates for regional or district-level towns, and
even lower rates for travel to “other areas” (Søreide, et al. 2012; 19). It is important to discuss with the
research team how much detail is needed when collecting data and presenting tables of rates.

4.1.4 Tips for data collection

Be aware that information on per diems may be very difficult to obtain. Public offices may not want to
share information, even if it is supposed to be publicly available. It may be helpful to rely on informal
relationships and collaborating organizations to obtain data.

In the government sector, different offices may be involved in regulating per diems. The sources of
data on per diems for public administration in general are also relevant for an analysis of per diems in
the health sector, as government policies generally apply to all public sector institutions. For example:

• In Tanzania, categories of allowances are defined in the Public Service Management

Department in the President’s Office
• In Malawi, categories are defined by the Human Resources Management and Development
Department in the Office of the President and Cabinet
• In Ethiopia, policies on per diems are set by the Council of Ministers
• In Uganda, data on per diem categories and rates are found in the Ministry of Public Service.

It is appropriate to ask whether donor support for health system strengthening (HSS), and all vertical
program funds that are provided by donors but managed through government accounting systems are
required to follow government per diem policies. If not, then additional policies governing these funds
should be sought.

Researchers may wish to contact:

• the Personnel, Finance or Planning office within the Ministry of Health

• the Administration office of specific donors responsible for HSS support, including the United
Nations, major bilateral donors, and projects funded by global finance institutions such as the
World Bank, Global Fund to Fight AIDS, TB and Malaria, or the Gates Foundation
• the Administration office of international and local NGOs operating in the health sector

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4.1.5 Interpreting and using the data

This tool is mainly used to collect descriptive information. The main use of the data is to help make
sure everyone involved has a common understanding of the policies, and to assess the completeness,
coherence, and transparency of the policies.

When assessing data from different organizations (e.g. an international organization versus
government agency), try to identify consistencies or differences. Does one organization allow per diem
to be paid within a duty station, but another explicitly prohibits this? Does one organization allow a
daily allowance if travel exceeds 6 hours, whereas another has a limit of 8 hours?

Inconsistencies in policies are to be expected and are not necessarily bad. But if people do not
understand the policies, they may assume they are more consistent than they really are. Also, if one
organization has policies which are perceived to be more favourable to workers (e.g. the allowance is
earned after 6 hours of travel instead of 8 hours), it may cause people to change work habits to favour
the trainings and meetings offered by the organization with the “better” policies.

If it was very hard to gather data from a certain organization (e.g. a government office claims that the
data are not “public”), if the policies are not up-to-date (e.g. you are told that rates have changed, but
the policy does not include the updated information), or if the policies are not available in writing for
any employee to see, this is a sign that transparency is lacking.

4.2 Tool 2. Policy characteristics and control systems

This part of the toolkit provides a standardized method for collecting and describing information on
travel and per diem policies and control systems of public and private organizations active in the
health sector within a country. The purpose of this information is to help you understand how policies
vary between different types of organizations (government agencies, NGOs, etc.). Rubin (2012)
observed during her study of per diem policies in Tanzania, that many times donors would state that
they follow government per diem policies, but did not. Or they would state they did not provide certain
allowances, but upon further questioning it turned out that they did. She concluded that:

an important step towards more coherent and harmonized policies and

practices across [development partners] is actually an internal exercise for
each [partner]. There needs to be a common understanding, on all levels
within the agency, about what allowances are, as well as of own policies and
goals within each agency. (p. 14)

This tool can help development partners to come to this common understanding. It is a critical first
step before analysing the weaknesses of current policies.

Below is a list of policy characteristics you should seek to document, with “key issues to clarify” for
guidance on items about which you should be clear. Unfortunately, the regulations governing per
diems are often spread out in different circulars and standing orders (Rubin 2012). The list is therefore
followed by tips on obtaining this information.

4.2.1 Policy characteristics

Policies on per diems generally should include definitions of allowable travel or work-related activities
eligible for per diem, per diem rates, policies on advances, policies on who is allowed to approve per
diem disbursement, and specifics on how per diems for workshops are handled. A description of
current policies can help all policy makers understand the components of current policies, and where
there may be ambiguity or unclear guidance. The following should be done for large organizations
which may be spending significant amounts on per diems.

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• Government agencies
• Other organizations
This category includes private organizations that fund and implement programs; for example:
international organizations such as the UN; funders such as bilateral donors (e.g. USAID,
PEPFAR, NORAD, GIZ) foundations (e.g. Gates Foundation), or global funding mechanisms (e.g.
Global Fund); and implementing agencies such as an international NGO which has contracted
with a donor to implement a project

Definitions of allowable travel (for workshops, conferences, meetings, etc.)

• Key issues to clarify:
o Does the policy clearly define situations when travel is allowable? Better policies
include clear definitions of allowable types of travel and specific allowable expenses
which may be reimbursed by the per diem. Weaker policies may use vague terms such
as “travel-related spending” without defining what is included. It should be clear what
expenses are meant to be paid by the per diem, and what can be separately
reimbursed. For example, personal calls may be considered part of the “incidentals”
portion of the per diem. But an employee may also be entitled to a phone card or
reimbursement for work-related phone calls separately, so clarity on these expenses is
important
o Are there restrictions on travel for which per diems are provided?
A better policy has some restrictions on travel, a weaker policy will not specify
restrictions, and may suggest to personnel that per diems are an acceptable way to
supplement staff income. Researchers should try to ascertain whether the system is
attempting to limit or control spending on per diems by stating restrictions. For
example, are there:
 Limits on number of days staff may travel per time period (i.e. maximum
travel days per month or annum), or restrictions on the type of hotel or
transport used?
 Geographical limits on where civil servants may travel (within home city,
district, state, etc.)?

Per diem rates, by staff rank or position

• A good policy will clearly define the components of per diems, specify the required
documentation, and make it clear how the rates vary. These definitions are important
components of transparency, so that workers are able to anticipate the documentation needed
and to manage their travel within the per diem rates. Key issues to clarify:
o Are the components of per diems clear and separately calculated? (e.g.
accommodation, meals, transport, incidentals)
• Is some documentation of travel (e.g. hotel receipt) required? Some policies offer a maximum
per diem but only reimburse the actual amount paid to hotel. A good policy will explicitly
state this.
• Do per diem rates vary by level of staff or salary grade (e.g. by the categories you have
identified in Part 1 of the toolkit)? Some experts do not recommend having rates that vary by
staff level or salary grade, since the expenses of travel should not really be different depending
on your grade. It is important to document current practices so that policies of different
organizations can be compared and the benefits and drawbacks of varying rates can be
discussed.
o Category 1

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o Category 2
o Category 3, etc.
• Do per diem rates vary by geographic location within the country? Or for travel abroad to
different destinations? A good policy will account for differences in the cost of travel to
different areas.

Policies on per diem advances provided to staff

Some organizations allow individuals to request an advance of per diem based on expected travel. This
can create vulnerabilities for abuse if the person curtails travel after having received the advance, or if
policies on accounting for advances are unclear or loose. A good policy is transparent in terms of
whether advances are allowable, any restrictions on advances (reasons an advance might be denied),
and documentation.
Key issues to clarify:
• Can staff receive per diems in advance of travel?
• Are there restrictions regarding who may receive advances (e.g. rural residents traveling to
urban areas) or certain types of travel for which advances are permitted?
• If advances are permitted, what documentation is required in the request?
• What steps are taken to assure that travel has actually taken place (i.e. boarding passes to
verify dates). See also section 4.2.2., below, on Controls.

Policies on who decides or approves travel and per diems

Point 2.1.1, above, defined allowable travel or activities through which per diem can be earned in
general. It is also important to ask questions about the specific process through which decisions are
made about who gets to travel and whether a request will be approved. A good policy will have clear
criteria for approving travel requests and a transparent process for approval. A good policy will also
have procedures to assure that the budget development process has adequate controls to prevent
padding with unnecessary per diem spending.

Key issues to clarify:

• Are there clear criteria on who is permitted to travel and receive per diems?
• How transparent is the system of approvals? A transparent system would have a way to inform
people about the process for requesting approval, the criteria by which decisions are made,
and the results of past decisions (i.e. when and why travel requests are approved or
disallowed).
• Do officials who approve travel and per diems have to provide explanations or justifications
for approved travel to higher-level staff? This question examines the level of bureaucracy or
hierarchical control (review and oversight by people higher in the system) involved in the per
diem system.

Policies on workshops and per diems

Sometimes organizations have different policies or procedures for per diems given during workshops.
Workshops hosted by the organization pose specific circumstances: there may be a need to provide per
diem payments in cash at a remote location, posing some risks. A financial officer may need to take a
cash advance to make these payments, and the processing of this type of advance may require
additional paperwork. In addition, verification of recipients of per diem is somewhat different, since
workshop participants may not be employees of the organization. Workshop per diem policies and
procedures may also need to account for different donor requirements if the workshop is funded by an

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external source. Good policies have detailed procedures for the dissemination of per diems given at
workshops. They also have adequately controlled cash management procedures. After collecting the
documentation in this section, the policy should be reviewed by an expert accountant (outside the
system) to assess whether cash management procedures provide adequate control.

Key issues to clarify:

• What are the policies for holding workshops and providing per diems?
• What are the processes for cash management and payment of per diems?

4.2.2 Control systems and procedures

Control systems tell you how an organization is attempting to assure that per diems are limited
systematically and how abuses will be handled. Control systems should ensure that per diem payments
are used for their intended purpose. Procedures should assure transparency in the approval and
disbursement processes, through the dissemination of written policies among staff, communication of
the criteria by which decisions are made to approve spending, and reports of past decisions and
spending on per diems.

Some areas to be understood include the types of procedures in place for approval of spending and to
minimize over-spending, how the health organization relates to other agencies (for example, some
control procedures might be performed by financial officers working for the District Administrator or
the Ministry of Finance, and verification or other checks might be conducted by the Inspector
General’s office). This section also asks about internal and external audit procedures, and any external
watch dog organizations.

An organization is more vulnerable to abuse of per diems if it lacks control procedures, or if the
controls are not well communicated or understood by the actors involved. In addition, this section
includes questions about detection and enforcement: are the controls successful in catching people
who are not following the rules or who are abusing the system? How are transgressions handled? A
well-functioning per diem system will show evidence of enforcing the rules.

In addition to assessing the procedures in place, it is also important to evaluate the transparency of the
control system: how are policies communicated to staff? How easy is it to find out the results of
control activities? Both the control process and its outcomes should be clear to people within and
outside the system.

An expert accountant may be helpful in assessing the completeness and adequacy of control
procedures. It may also be helpful to review past audit reports which may have findings related to the
control procedures, if the organization is willing to share them.

4.2.2 should be done for:

• Government agencies
• Other organizations
This category includes private organizations that fund and implement programs; for example:
international organizations such as the UN; funders such as bilateral donors (e.g. USAID,
NORAD); foundations (e.g. Gates Foundation); and implementing agencies such as
international NGOs which have contracted with donors to implement projects.

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Formal controls on travel and per diems

Key things to clarify:

• What controls have been formally established?
o Needed approvals. If a request for per diem is submitted by an employee, who must
approve the request before it is paid?
o Budget checks. Is there a procedure established whereby an official will check to
assure that the organization’s budget has adequate funds, before a per diem request is
approved?
o Controls on double payments of per diems (e.g. from donor and government). Are
there any procedures in place to prevent a person from receiving per diem from two
places at once, for the same travel? For example, is it possible for a staff member to
attend a training workshop, receive per diem from a donor, and also request and
receive funding from the government for attending the same workshop?
o Ex post controls. Are receipts, proof of attendance, etc. required, including where per
diems have been paid in advance.
• Which agencies are involved? For example, in a health district, are the needed approvals,
budget checks, and other controls required by staff from the district health office? Or are some
controls performed by the Ministry of Finance, the District Administrator’s office, or the
Office of the Inspector General?
• For each agency involved in control procedures related to per diems, define the specific
responsibilities regarding control of per diem payments.
• Who is the controlling officer or staff member, e.g. who authorizes travel, decides which
allowances may be provided? If there is no controlling officer identified, the system is more
vulnerable to abuse. The person authorized should have a good understanding of the policies,
and should be perceived as fair and impartial.
• Are there systematic or formal controls to ascertain whether seminars and trips are required
for job performance?
• Are existing controls enforced? If so, how? Are results of enforcement of abuse
communicated to staff?

Internal audit units

Key issues to clarify:

• Has an internal audit unit been identified with a role in controlling per diems? What is the
name of the unit and where does it sit?
• What are the unit’s specific responsibilities regarding control of per diem payments? For
example, does it review documentation to be sure appropriate signatures have approved
spending? Does it contact staff to check whether they have actually received the per diem they
reportedly received? The goal is to see whether the controls are adequate to detect abuses
which people may mention in the survey (Tool 4) as being important.
• Is the role (or the decisions) of the internal audit unit enforced? In some cases, an organization
can have a robust internal audit unit, yet the management structure does nothing with the
results. If this is the case, then adding more control procedures is unlikely to have added value
in reducing risk of abuse. Instead, ask why the audit findings are not enforced. Is it that
management lacks tools or authority to make changes? Or do managers feel that this is not a
priority? This information can help to target recommendations for improvement.

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External audit units

Key issues to clarify:

• Is there an external audit unit (or more than one unit) with a role in controlling per diems?
(e.g. supreme audit institution, private audit firm, etc.)
• What are the unit’s specific responsibilities regarding control of per diem payments?
• Is the role (or decisions) of the external audit unit enforced? How?

“Watchdog” organisations

Key issues to clarify:

• Are agencies requested to publish information on their per diem policies and spending, and/or
to provide access to this information on request?
• Are there any ‘watchdogs’ such as mass media and civil society organisations that help hold
the government to account?
o If yes, obtain their reports. For example, in Tanzania, local civil society organizations
Sikika, and Policy Forum, have analysed per diem expenditures and per diem policy
implementation (see for example Policy Forum 2009).

Punishments for breaking the rules

Key issues to clarify:

• Are there rules on disciplining people who break the rules on per diems?
• Is there any experience with people breaking the rules and being disciplined?
• Are results of case detection and punishment made public in the organization?

4.2.3 Contextual factors

Characteristics of the economy that may encourage high per diem payments
• Are wages for civil servants chronically low?
o Do staff complain about their wages?
o Are public salaries comparable to private sector salaries, much higher or lower? Does
this relation differ across health professionals (e.g. doctors being better paid than in
private sector while nurses are not)?
o Has inflation outstripped wage increases in recent years?
• Have recent developments put pressure on use of per diems (e.g. rising unemployment,
inflation, other economic crises or signs of unrest)? These characteristics encourage high level
officials or staff to allow/approve per diems in order to increase wages for civil servants and
staff.
• How frequently are per diem rates updated? Infrequent updating of lists can be a problem in
inflationary economies.
• When was the last time per diem rates were updated?

Other contextual factors to consider

• How easy is it to obtain information on per diems?

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• Have there been attempts to control per diems in the past? For example, in Tanzania the
Controller and the Auditor General’s Office noted that per diem spending is excessive and
drew attention to this issue so that the executive and legislative branches of government could
make more informed decisions on public resource management. This is a sign that some
government stakeholders believe this issue is important and could use additional information
on the topic. Another issue to explore is whether development partners have made concerted
efforts to coordinate policies or control spending on per diems. Looking in the past 3-5 years
should be sufficient.
• Are there reports in the media of excessive use or abuse of per diems?
• Is there pressure to harmonize rates across donors and government, or across different donors?
If NGOs actually finance per diems themselves (rather than spending donor or government
money under sub-contract), then it may be important to examine any efforts at harmonization
among NGOs as well.

4.2.4 Tips on collecting this information

For government rules and regulations:

• In most countries, there is one government office that prepares all the documents that contain
the rules and regulations on travel and per diems for civil servants. It may be the Ministry of
Finance, or it may be the President’s Office. Sometimes, countries provide these documents
on a government website. These documents are almost always public and available, but
sometimes obtaining them can take persistence. You should be prepared to visit government
and organization offices to obtain the documents.
• If you are speaking to an official or staff person and he/she mentions a rule or a policy, ask for
the document. You can ask: “is that written down somewhere?” and “can I have a copy?” You
can offer to make a copy yourself. You can also take a photo (using cell phone or camera) of a
document that is impossible to copy.
• If you cannot obtain or look at the document itself, ask for the circular number, policy number,
etc. Ask where you might be able to find the document. Be sure to write down all information
that may help you track down the document.
• For government rules, you want national level policies. However, many countries have rules
and policies at lower levels, so you will probably also want at least one lower-level (province,
state, or district) set of rules or policies.
• You should also confirm whether different ministries (i.e. health versus education or finance)
use different rules since often certain rules and policies vary across ministries and departments

For international organizations:

• Many documents are available on United Nations (UN) websites. Policies of bilateral donors,
and global funding mechanisms or international finance organizations may need to be
obtained through their administrative offices.

For non-government organizations

For non-governmental organizations, you do not need to be exhaustive in covering all NGO policies.
Instead, strive to obtain one or more illustrative examples.

Once you have the documents, it is best if you can confirm that you have the latest version. Thus,
when you speak to a government official or an agency staff person, ask them to confirm that the
document you have is the latest version.

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4.3 Tool 3. Per diem spending

An important aspect of per diem payments is the amount of budget allocated to per diems, and how
this spending compares to other investments. This component sets out indicators of per diem spending
and specifies the data needed to calculate the indicators. This information can be used to: i) help
determine a baseline against which current policies can be evaluated, ii) measure reform progress, and
iii) make international comparisons.

The analysis is done at the national level, because many of these indicators are only available at the
national level. The data are still useful to quantify the situation generally. If data exist, the analysis
could also be undertaken at the level of the health sector, but this depends on how health sector
spending is accumulated and reported. If spending is decentralized, it may be harder to conduct a
sector-specific analysis.

Please remember that per diems are defined as prospectively-determined daily subsistence allowance
for approved travel within or outside of duty area (see Tool 1 for details).

4.3.1 Indicators

Indicators are for government. These could be adapted to other organizations, as well.
Indicator 1: Per diem spending as percentage of total wage bill (payroll + allowances)
As this analysis has not been conducted in many countries, it is hard to benchmark. According to one
study, per diem spending in Tanzania was 16% of total wage bill, and 22% in Malawi (Søreide, et al.
2012)
Indicator 2: Per diem as percentage of all allowances
Divide all allowances into two types, “duty enhancing” (per diems) and “remunerative” (housing,
transportation subsidy, school fees). There are no benchmarks available for this analysis.
Indicator 3: Total per diem spending as proportion of government budget
As this analysis has not been conducted in many countries, it is hard to benchmark. Per diem spending
in Tanzania was 1.6% of total government budget, and 6% in Malawi (Søreide, et al. 2012)
Indicator 4: Total per diem spending as a proportion of GDP (first show wage bill as proportion
of GDP)
As of now, there are no benchmarks for this indicator. The number should be small. It can be used to
analyse the economic impact of changes to per diem policies
Indicator 5: Average per diem spending per worker
As of now there are no benchmarks for this indicator. This indicator will help show the magnitude of
per diem spending averaged across the workforce.
Indicator 6: Average annual per diem spending per worker as a proportion of average annual
salary
As of now there are no benchmarks for this indicator. This would illustrate the remunerative impact of
per diem policies, i.e. how they add to average salary.
Indicator 7: Per diem rate compared to average daily salary (level specific)
In Uganda, the ratio of per diem rate to average daily salary rate ranged from 2:1 (for high-level
officials like medical officers) to 9:1 (for lower level staff such as nursing assistants and drivers)
(Vian, et al. 2012)

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4.3.2 Data needed

Data are from national budget.

1. Total spending on per diems. They may only have allowances, and not be split out by per
diems. If so, look for detail in one agency.
2. Total wage bill. This includes salaried workers, non-salaried (wage), and all allowances.
3. Total spending on salaries and wages alone (no allowances).
4. Total spending on all allowances, including per diems.
5. Total annual government recurrent budget
6. Total annual GDP
7. Number of government workers
8. Number of working days per year (260 minus official government holidays, minus average
vacation days per worker per year)

4.4 Calculating indicators

Table 3.1 shows how the data collected can be used to calculate desired indicators of per diem
spending. See Annex A for a sample table with filled in data.
Table 3: Indicators of per diem spending
Basic country data Year of interest
Input actual data
Total spending on per diems A
Total wage bill (including allowances) B
Total value of all allowances C
Total spending on salaries and wages (excluding allowances) D
Total annual government recurrent budget E
Total annual GDP F
Total number of government employees G
Key indicators Formula
Total per diem spending as % of total wage bill =A/B
Total per diem spending as % of all allowances =A/C
Total per diem spending as % of national government budget =A/E
Total per diem spending as % of GDP =A/F
Average per diem spending per government employee =A/G
Average annual per diem spending per government employee as % of =(A/G)/(D/G)
average annual salary (excluding allowances)
Per diem rate compared to average daily salary
Level 1
Level 2
Level 3

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Sources:
• For GDP and the number of government employees, through year 2011, follow this link:
• http://databank.worldbank.org/Data/Views/VariableSelection/SelectVariables.aspx?source=World%20Deve
lopment%20Indicators%20and%20Global%20Development%20Finance
• For total government wage bill, through the year 2008, follow this link: http://data.worldbank.org/data-
catalog/wage-bill-pay-compression
• For government budgets, go to the individual country Ministry of Finance websites, where data may be
publicly available. For example, for Malawi follow this link:
http://www.finance.gov.mw/index.php?option=com_docman@task=cat_view%gid=56%Itemid=55
• For wage rates for different types of employees (public administration is one category), see the
International Labor Organization (ILO) databases at this link: http://laborsta.ilo.org/STP/guest
• Spending on per diems, wages, and other allowances may be found through analysis of government
budgets (see #2 and #3 above). If these are not available online, you may request a budget book at the
Ministry of Finance, or World Bank office locally. Budget data may also be available in some grey literature,
such as Hunting for Per Diem, and through local civil society watchdog organizations such as Policy Forum in
Tanzania http://www.policyforum-tz.org/ or ELBAG (Economic Literacy & Budget Accountability for
Governance) http://www.elbag.org/main/index.php?option=com_content&view=article&id=19&Itemid=53

4.5 Tool 4. Survey on attitudes and practices

This component provides a survey instrument and guidance on how to conduct a sample survey of
workers to assess attitudes and practices related to per diems. Including both quantitative and
qualitative questions, this survey is intended to measure personal experience with per diems (amount
of money earned), knowledge about per diem policies, attitudes toward per diems, perceptions about
risks or abuses, and opinions about reform.

Similar to corruption perception surveys, this type of data collection can help policy makers to set
priorities for what problems are most pressing and need intervention, and help determine baseline
information against which to measure reform progress. A survey sample can be found in Annex B.
Below are the main elements of the survey:

4.5.1 Survey components

Personal experience with per diems (3 month recall period)

Personal experience will help to estimate the impact of per diems on personal finances, and show the
relative importance of major types of per diem earning activities. With these data, we can start to see
travel patterns and how they vary. Are there some employees who travel a great deal? What portion of
their time are they traveling, and for what purposes? Is travel mainly overnight, or are people earning
significant amounts of per diem from daily allowances which do not require overnight stays? These
data can help describe per diem-earning employees, and identify patterns that might relate to specific
kinds of jobs. The data might be especially important if it is not possible to use Tool 3 (per diem
spending) applied at the national level. At least using the survey, one can gather a sense of the how per
diem payments relate to salary, and the remuneration effect of per diems.

• Number of days spent in activities which earn per diems

o Days spent away from duty station and amount of per diem earned per day, by type of
activity. There are four categories of activity: training, project oversight or monitoring
& evaluation, meeting or conference, and other.
o Days spent at duty station and amount of per diem earned per day, by type of activity
(using the categories described above).
• Total amount received in per diems

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Knowledge

Knowledge questions will test how well individuals understand the current per diem policies and
procedures. These questions may need to be tailored to local context. Please look at the first question
on actual per diem rate, and fill in correct number in advance of administering the survey. Also please
note the correct answer to each of these questions before administering the survey. If the answer to a
question is ambiguous, or the question itself is irrelevant, please modify as appropriate. Higher
knowledge may indicate greater policy transparency. Low knowledge may help explain why policies
are not being followed, or may increase the risk for abuse of per diems.

• Knowledge of current per diem rate for someone at his/her level (compare answer to correct
rate)
• Knowledge of processes to document receipt of per diem, or to get advances (compare answer
to correct procedure)
• Knowledge of how violations are handled
• Knowledge of complaint mechanisms (able to list at least one correct action to take if the
person has a complaint about approval or spending of per diems)
• Open-ended questions related to perceived knowledge level, other comments on knowledge

General attitudes

Attitude questions measure satisfaction with current per diem policies and perceived importance of
different issues. These are 5 point scale (disagree-agree) and some open-ended questions. Since staff
are important stakeholders, the questions can help determine staff interest and motivation in
maintaining the status quo versus implementing policy change, and how much influence they may
have in this process.

• Satisfaction with per diem policies

• Perception of issues. Some specific issues have been raised in qualitative research as concerns.
This section asks people whether they think these issues are important.
o 6 categories:
 Adequacy of rates to cover true cost of travel
 Whether rates should permit savings (above cost of travel)
 Differences in rates by cadre
 Opportunities to earn per diems
 Negative impact on how people spend their time
 Abuse or corruption
o Open-ended question on what issue is most important

Perception of abusive practices

This section explains that it is hard to define “abuse.” It gives a general definition of abuse, then asks
for the respondent’s opinion on whether certain practices related to per diems should be considered
“abuse”. The abusive practices were determined from a review of two studies: Søreide, Tostensen and
Skage (2012) and Vian, Miller et al. (2011). As with section 4.1.3, these questions may help determine
stakeholder interest in maintaining the status quo versus implementing policy changes, and entry
points for advocacy.

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• List of 9 practices (from qualitative studies).3 Ask yes/no opinion if this can be considered
abuse.
• Open-ended question about other abuses, and which abuse(s) are most important
• Opinions on reform
• This section asks respondents what they know about efforts to reform per diem policies, and
what they think should be done. These questions will help elicit local experiences with reform,
ideas about the feasibility of reforms, and perceptions of the power of different stakeholders.
• Open-ended question about what the organization has done to improve per diem policies or
prevent abuse
• Open-ended question about what more needs to be done to improve policies/prevent abuse

Demographics

This section collects some demographic characteristics such as age, gender, level of position, and
salary (in order to put per diem earnings in perspective).

Tips on collecting this information

• This questionnaire is designed to be a mini-survey. It is meant to get a sample of opinions, not
to be an exhaustive study of all aspects of per diem policies. The maximum number of
questions should be close to 40, and the survey should take a maximum of 30 minutes to
complete.
• Questions are largely closed, so that statistical analysis can be done quickly. There are a few
open-ended questions so that respondents can provide contextual detail. Be aware that one
limitation introduced by open-ended questions is that data collectors may edit answers to
simplify. This could distort responses. Interviewers need to be well trained and supervised.
• The use of probability sampling is preferred, so that each individual has equal likelihood of
being selected. This permits generalization of findings. One could choose a random sample
from the personnel records of an organization, for example. But if representative sampling is
not feasible due to time and resource constraints, informal sampling procedures may still be
used. Examples of informal or convenience sampling include snowball sampling (asking each
informant if they know someone else who could be an informant) and purposive sampling
(choosing informants based on an appropriate characteristic such as job title or experience
with per diem payments). Be aware that such results must be interpreted with caution because
they may be biased.
• People using this survey may decide to drop some of the demographic questions (e.g. age,
gender, and cadre). Simple analysis of frequencies will not require demographic data. But the
data on income is needed to analyse the ratio of per diem income to salary and other
allowances.
• This questionnaire may need to be adapted to context, especially the questions on knowledge.
The questionnaire should be pre-tested with 5-10 respondents before using. The pre-test
should consider whether the meaning of questions was clear, whether respondents have
difficulty answering questions, whether response categories are appropriate, and whether there
is acceptable variety in responses. The amount of time it takes to administer the questionnaire
should also be noted.

3 Over-estimating time needed, inventing unnecessary work, working slowly to increase per diem, claiming
more days than actually worked, diverting per diem budgeted for another person, claiming twice for same
activity, attending multiple workshops in a day, falsifying participant lists, attending unnecessary training

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The 41-item survey instrument is found in Annex II.

4.6 Tool 5: Planning for dissemination

The first four tools deal with data collection and analysis. This tool provides suggestions for ways in
which policy analysis can be used to stimulate discussion about and generate commitment to reform.

In reporting on the data collected, the policy analysis should draw attention to the positive aspects of
policies—areas where the policies are clear, consistent, and appear to be well understood and
followed. The analysis should also highlight inconsistencies or areas where transparency is lacking.
For example, are there practices which exist on paper but are not followed? Do stakeholders have
perceptions about per diems which seem at odds with described policies and practices?

• Analysing the problems with per diems—documenting how much is being spent, who is
benefiting, and how per diem systems are vulnerable to abuse—is a first step to reform. But
the results of policy analysis must be used to educate people on this problem, and to engage
them in reform discussions.

Officers at all levels of the system are likely to have ideas on how to reform the system to be more
equitable and to reduce opportunities for abuse. A dissemination strategy should support the
development of policy reform strategies grounded in evidence, and addressing the roles and
contributions of government institutions as well as of NGOs and development partners.

• To disseminate the results of policy analysis, we suggest using web sites, meetings, and the
media. A first step is to develop written products, including a research report, policy brief, and
press release. Each of these products is tailored to a different audience, but the overall purpose
is to educate and stimulate engagement among a wide range of stakeholders.
• Who are the “stakeholders” to be educated about and involved in efforts to reform per diem
policies? They include:
• government officials with authority to make or influence policy related to human resources
management and allowances;
• government staff who make decisions related to approving program plans and spending travel
budgets;
• government staff at different levels in the system who travel for work and earn per diems;
• international and local NGOs who provide per diems to their own staff and host events where
per diems are offered;
• donor representatives who fund activities where per diems are earned, provide budget support
to government, and provide contracts to NGOs engaged in capacity-building (and per diem-
earning) activities;
• civil society watchdog organizations engaged in budget transparency and holding government
accountable for effectively delivering services the citizens want and need;
• research institutions who might be interested in further analysing and comparing data;
• media organizations which provide external accountability and are engaged in informing the
public.

4.6.1 Research report

The research team should document their findings in a written research report (25-30 pages) and a
strong executive summary with main findings and recommendations. Findings should be organized to
roughly match the tools:

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• types and categories of allowances, with a focus on daily subsistence allowances (per diems);
• per diem policy characteristics and country contextual issues influencing the situation;
• per diem spending indicators;
• survey results
• The survey results include two parts: 1) the data on percentage of time spent in per diem-
related activities (gleaned from number of days of per diem earned during the recall period)
and amount earned in per diems by the survey respondents; and 2) attitudes and opinions
about per diems.
• The research report should include a discussion of the implications of the findings, including
the main drivers of the problem and perceived negative consequences. It should also include a
set of possible reform options or issues to discuss further with stakeholders. The full research
report should also be made available to other researchers who may want to do sub-analyses or
comparisons with the data.

4.6.2 Policy brief

Many higher level officials will not have time to read a full research report. Therefore, a second
dissemination document should be a policy brief (4-5 pages) summarizing the per diem problem in the
country using the evidence collected. The policy brief should outline the reform options, and suggest
some pros and cons of each.

4.6.3 Press release and social media

• A press release should be written that describes the findings of the analysis for a lay audience.
This can be disseminated to local newspapers and to international listservs. In addition, a
specific strategy for social media may be developed, including twitter messages and Facebook
postings, to guide people to the other reports and summaries

4.6.4 Dissemination tools: presentations, town meetings

• It is important that any meetings to disseminate the study findings should not pay per diems to
attendees. The format of meetings should be conducive to discussion—the findings should not
be presented for longer than 15 minutes. One way to assure adequate time for discussion is to
prepare a presentation with a recorded voice-over, or film a video created to explain the issues
to audiences.
• Following the presentation, small groups should be formed to discuss the results. Discussion
questions might include:
• Do these findings seem to reflect the true situation? What parts seem accurate, and what was
surprising, or seems like it might not be right?
• What are the most serious negative consequences of per diems in your view?
• What reforms should be implemented to reduce the negative consequences of per diems?
• If you had a chance to talk to an official in charge of per diem policies, what would you say?
What one thing would you want them to know or to do?

The idea is to support increased awareness of the problems caused by per diems, and to support local
problem-solving on the issue. Meetings should be held at locations in the periphery as well as central
offices, to engage people who are discontented with the current system and have ideas and interest in
reform.

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4.7 Tool 6: Further reading and resources

People who would like to read more on this topic may appreciate the following resources.

• Chêne, M. (2009). Low salaries, the culture of per diems and corruption. U4 Expert answer.
Retrieved 3 August 2010, from http://www.u4.no/helpdesk/helpdesk/query.cfm?id=220
• Grepin, K. (2009). The per diem culture. The Global Health Blog. Retrieved October 1 2009,
from http://karengrepin.blogspot.com/2009/07/per-diem-culture.html
• Hanson, S. (2012). Need to reform the remuneration system to initiate a system approach to
the health sector in resource-poor countries. Trop Med Int Health, 17(6), 792-794.
• Jack, A. (2009). Expenses culture has high cost for world’s poorest nations. Financial Times
Retrieved 20 November 2009, from www.ft.com/cms/s/0/832f89ea-7c4f-11de-a7bf-
00144feabdc0.html?nclick_check=1
• Policy Forum. (2009). Reforming allowances: A win-win approach to improving service
delivery, higher salaries for civil servants and saving money. Policy Brief 9.09 Tanzania:
Policy Forum.
• Ridde, V. (2010). Per diems undermine health interventions, systems and research in Africa:
Burying our heads in the sand. Editorial. Tropical Medicine and International Health.
• Roenen, C., Ferrinho, P., Van Dormael, M., Conceicao, M. C., & Van Lerberghe, W. (1997).
How African doctors make ends meet: an exploration. Tropical Medicine and International
Health, 2(2), 127-135.
• Rubin, E. (2012). Assessment of DP practices in Tanzania in financing allowances, salary top-
ups, civil servant salary payments and parallel and/or integrated PIUs. Assessment report.
http://www2.tzdpg.or.tz/uploads/media/Assessment_of_allowances_practices_-
_FINAL_Feb_1st_2012.pdf Accessed September 9, 2012. Dar es Salaam, Tanzania: Tanzania
Development Partner Group.
• Søreide, T., Tostensen, A., & Skage, I. A. (2012). Hunting for per diem: The uses and abuses
of travel compensation in three developing countries. Oslo, Norway: Chr. Michelsen Institute
for Norwegian Agency for Development Cooperation (NORAD).
http://www.cmi.no/publications/publication/?4436=hunting-for-per-diem
• Vian, T. (2009). Benefits and drawbacks of per diems: Do allowances distort good governance
in the health sector? U4 Brief No. 29. November 2009 Bergen, Norway: CMI, U4 Anti-
Corruption Resource Centre. http://www.u4.no/publications/benefits-and-drawbacks-of-per-
diems-do-allowances-distort-good-governance-in-the-health-sector/
• Vian, T., Miller, C., Themba, Z., & Bukuluki, P. (2011). Perceptions of per diems in the
health sector: Evidence and implications. U4 Issue Paper No. 6, June 2011. Bergen, Norway:
U4 Anti-Corruption Resource Centre, Chr. Michelsen Institute.
http://www.u4.no/publications/perceptions-of-per-diems-in-the-health-sector-evidence-and-
implications/
• Vian, T., Miller, C., Themba, Z., & Bukuluki, P. (2012). Perceptions of per diems in the health
sector: evidence and implications. Health Policy & Planning.

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www.U4.no

Annex I: Sample table of indicators of per diem spending

Basic Country Data

Year 2010 1 Source
A. Total spending on per diems 20872 Estimate
B. Total wage bill (including allowances) 260900 http://www.the-star.co.ke/business/local/75952-employers-paid-out-sh878bn-in-wages-last-year
C.Total value of all allowances 41744 Estimate
D. Total spending on salaries and wages (excluding allowances) 219156 (=B-C)
E. Total annual government recurrent budget 691563490 http://www.knbs.or.ke/Classification%20of%20Government%20Expenditures%20by%20Functions%20of%20Government.php
2
F. Total annual GDP 2.55116E+11 http://data.worldbank.org/country
G. Total number of government employees (number) 663400 http://www.knbs.or.ke/Labour_Basic_Min_wages.php
Per diem policy analysis toolkit

Key Indicators
Total per diem spending as % of total wage bill (A/B) 8.0%
Total per diem spending as % of all allowances (A/C) 50.0%
Total per diem spending as % of national government budget (A/E) 0.003%
2
Total per diem spending as % of GDP (A/F) 0.00001%
Average per diem spending per government employee (A/G) (KSh) 31462

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Average annual per diem spending per government employee
as % of average annual salary (excluding allowances) (A/G)/(D/G) 9.5%
Per diem rate compared to average daily salary
3
Average daily wage (excluding allowances) ((D/240)/G) (KSh) 1376
Level 1 (per diem rate = 10,000/day) 7.26 per diem rates: http://pdf.usaid.gov/pdf_docs/PNADK126.pdf
Level 2 and 3 (per diem rate = 6,000/day) 4.36
Level 4 and 5 (per diem rate = 4,000/day) 2.91
1
Figures in Million Ken sh, unless noted otherwise.
2
An additional useful indicator would be average per diem spending per government employee as
% of GNI (gross national income) per capita. For Kenya in 2010: estimated average per diem
spending per goverment employee = 31,462 Ksh and GNI per capita = 62,664, so this indicator
3
Assumes 240 working days/year.
U4 Issue 2012:8
U4 Issue 2012:8 Per diem policy analysis toolkit www.U4.no

Annex II: Survey on attitudes and practices

Introduction:

We are conducting a study that aims to improve policies for human resources management in
developing countries, especially policies related to per diems. As part of this study, we would like to
ask some questions about your experiences with and opinions about per diems and possible abuses of
per diem policies by workers.

By per diem we mean a daily allowance, usually determined in advance, paid by an employer,
development agency or client, to cover approved employee expenditures such as lodging and meals
when away from post.

By abuse we mean when official rules are deliberately broken, or the intent of the policy is

A. Personal Experience with per diems:

This section deals with actual experience of respondents in terms of receiving per diem, for what
kinds of activities, involving time away from post or not, and how much they have received.

In the questions that follow, I will ask you about the time you spent on activities for which you
received per diem, and the amount that you received in per diem. If you don’t know exact numbers
please estimate as best you can.

A1. In the last 3 months, how many days total did you participate in an activity for which you
received per diem?

__________ (number of days)

A2. For the above activities, how much total did you receive in per diem?

__________ (amount in local currency)

A3. Of the total days you participated in per diem-earning activities, how many were spent away
from your duty station (home city/town)? (If 0, skip to A5.)

__________ (number of days)

A4. For these days spent away from your duty station, please tell me the number of days spent
on the following activities, and the rate you received per day on each activity:

(Interviewer: Ask questions by type of activity to fill in the first 2 rows of the table. You will
need to total the number of days, and total earned in per diems yourself. Be sure to total
across the third row (“Grand Total” is total earned in per diems from all types of activities).

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Training Project Meeting or Other Total

Oversight/ conference
monitoring &
evaluation
Number of A4a. A4d. A4g. A4j. A4m.
days

Rate per A4b. A4e. A4h. A4k.

day
Total A4c. A4f. A4i. A4l. A4n.
earned in Grand
per diems Total:

(Interviewer: please add check that the total number of days in A4n is equal to the number in
A3. If they are not the same, please follow up and reconcile the numbers with the
participant.)

A5. Of the total days you participated in per diem-earning activities, how many were spent in
your home town/city? (If 0, skip to A7.)

__________ (number of days)

(Interviewer: please check that the total number of days in A3 and A5 is equal to the number
in A1. If it is not, please follow up and reconcile the numbers with the participant.)

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A6. For these days spent in your home town/city, please tell me the number of days spent on the
following activities, and the rate you received per day on each activity:

(Interviewer: Ask questions by type of activity to fill in the first 2 rows of the table. You will
need to total the number of days, and total earned in per diems yourself. Be sure to total
across the third row (“Grand Total” is total earned in per diems from all types of activities).

Training Project Meeting or Other Total

Oversight/ conference
monitoring &
evaluation
Number of A6a. A6d. A6g. A6j. A6m.
days

Rate per A6b. A6e. A6h. A6k.

day
Total A6c. A6f. A6i. A6l. A6n.
earned in Grand
per diems Total:

(Interviewer: please check that the total number of days in A6n is equal to the number in A5.

Also check that the total amount earned in per diems (#6n.) is equal to the amount in A2.)

B. Knowledge of Policies and Procedures

The next few questions are about the actual policies and procedures currently in place in your
organization related to per diems. These are true/false questions.

B1. The per diem rate paid to a nurse who leaves her duty station to True False Don’t
travel to the capital city for an overnight stay including know
accommodation is _____(rate should be filled in before
administering the survey).
B2. Official documentation of per diem payment need only list the total
amount paid to the worker, not the number of days.
B3. There is no official procedure for returning an unspent per diem
advance.
B4. Per diem income is taxable.
B5. It is possible to complain anonymously to the government if I think
per diem policies are being abused.
B6. If a supervisor breaks a policy or rule related to per diem payments
he or she will be disciplined.

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B7. How would you rate your own understanding of per diem policies and procedures in your
organization?

___Very good

___Good

___Neither good nor bad

___Bad

___Very bad

B8. Is there anything more you want to tell me about your understanding of per diem policies
and procedures in your organization? Yes No

If yes:

B8a. _________________________________________________________________________

C. Attitudes toward per diems:

This section focuses on your attitudes and opinions about per diems. For each of the following issues,
state whether you strongly disagree, disagree, neither agree nor disagree, agree, or strongly agree. In
answering these questions, please think about your own organization.

Strongly Disagree Neither Agree Strongly

Disagree agree nor Agree
disagree
C1. I am satisfied with the per diem
policies in my organization.
C2. Current per diem rates in my
organization are generally adequate
to cover the actual cost of travel.
C3. In general, I think per diem rates
should be high enough to allow
workers to save money for family
expenses or future purchases.
C4. Current per diem rates in my
organization allow workers to save
money for family expenses or future
purchases.
C5. In general, I think it is fair to have
different per diem rates by cadre or
level of worker.
C6. Opportunities to earn per diem in
my organization may not be
distributed equally, but they are fair.
C7. Per diems change how people spend
their time because they try to
maximize per diem income.

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C8. Per diem policies in my organization

are often abused.

C9. What do you think is the most important issue about per diems?

______________________________________________________________________________

______________________________________________________________________________

D. Per Diem Practices and Abuse

The idea of “abusing per diems” is not well understood. In general, abuse refers to improper actions
for a bad purpose, often to unfairly or improperly gain benefit. Abuse of authority related to per
diems may involve using authorized power or discretion for illegitimate private gain. We would like to
know your opinions about how to define abuse of per diems.

For each item in the following list, please state whether you think it should be considered “per diem
abuse”.

Yes No Don’t It
know depends
D1. Over-estimating time needed for an activity to earn more per
diem

D2. Inventing work, such as unnecessary trips, to earn more per

diem

D3. Working slowly in order to get extra per diem

D4. Claiming per diem for days that were budgeted to be in the
field or at a workshop, even if the work takes less time

D5. Keeping per diems originally budgeted for another person

such as a driver

D6. Getting per diems from two sources at once for the same
activity

D7. Claiming per diem from multiple workshops in one day

D8. Falsifying participant lists in workshops to claim per diem

D9. Going to a workshop which is not needed for your job

D10. Are there other types of abuse that I did not mention but which you think are important?

Yes No

D10a. If yes, please tell me about them.

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______________________________________________________________________________

______________________________________________________________________________

D11. Which type or types of abuse do you think it is most important to try to prevent?

______________________________________________________________________________

______________________________________________________________________________

E. Reform Efforts:

In this section of the survey we would like your opinion about per diem policy reform.

E1. Can you describe any actions your organization has already taken to improve policies or
prevent abuse of per diems? Yes No

E1a. If yes, please tell me about them.

______________________________________________________________________________

______________________________________________________________________________

E2. What other types of actions do you think should be taken to improve policies or prevent
abuse of per diems?

______________________________________________________________________________

______________________________________________________________________________

F. Participant Demographics:

F1. Age: ____________ (age in years)

F2. Gender Male F Female

F3. Level of worker (provide cadre/staff types for respondent to choose from)

F4. What is your monthly salary (excluding any additional benefits such as housing allowance,
education support, transportation subsidy, etc.)? ____________ (You might want to provide
ranges that are appropriate for the country.)

F5. What is the approximate value of additional benefits you receive, including housing
allowance, education support, transportation subsidy, etc?

__________________ (local currency)

END OF SURVEY

THANK PARTICIPANT FOR HIS/HER PARTICIPATION

34
U4 Anti-Corruption Resource Centre
Chr. Michelsen Institute (CMI)
Phone: +47 47 93 80 00
Fax: +47 47 93 80 01
[email protected]
www.U4.no
P.O.Box 6033 Bedriftssenteret
N-5892 Bergen, Norway
Visiting address:
Jekteviksbakken 31, Bergen
This U4 Issue is also available at:
www.u4.no/publications

INDEXING TERMS:
per diem
abuse of per diem
wages
human resource management
motivation
incentives
control
travel
fraud

Cover image by
Emily Barney on flickr.com
Most organizations use per diems as a way to reimburse out-of-pocket expenses for travel
and to encourage staff to attend professional development activities. However, weaknesses
in policy design and control of spending can cause problems, including distortions of
human resource systems, fraud and abuse by staff. Governments and non-governmental
organizations need to adopt and implement fair, transparent, and efficient policies which
provide adequate compensation for work-related travel without creating adverse incentives.
This toolkit proposes a methodology to study per diem policies of the health sector in a given
country, in government, international, or non-governmental organizations. It presents tools
designed to describe and analyse the different types of per diems, policy characteristics and
control systems, per diem spending, and attitudes and perceptions of staff as a means for
identifying corruption risks. Our goal is to help governments and collaborating development
partners assess their specific problems, and begin to develop solutions. While the toolkit was
designed for the health sector, it can also be applied to other sectors with little adaptation.

Anti-
Corruption
Resource
Centre
www.U4.no