The issue of corruption – defined here as ‘the abuse of public office for private gain’[1] or “enticement to wrong by improper or unlawful means,”– in the health sector is a concern to policymakers in all countries. It is a broad concept that covers a wide range of practices and each form of corruption may have different causes, consequences and solutions. Despite the variations in definitions and interpretations on what constitute corruption, there is a broad consensus and much anecdotal evidence that the presence of corruption in any form in the health sector can be detrimental to a country’s ability to improve the health of its population. It might have the impact of reducing the resources effectively available for health, discouraging people to use and pay for health services and ultimately limiting population access to quality healthcare and financial protection. While corruption affects the entire population, it is typically the poor who are most susceptible. When corruption is endemic, residents in poor and middle-income areas report more waiting at public clinics and a higher frequency of being denied access to immunization services than residents in rich locations[2]
Significant proportion of it in the health sector is a reflection of general problems of governance, public sector accountability and other forms of institutional inefficiency – political instability, bureaucratic red tape and weak legislative and judicial systems. Studies have shown that in the context of weak governance, high levels of health spending do not necessarily translate into improved health status[3]. Countries where there is broad adherence to the rule of law, transparency and trust, effective public sector structured on strong accountability mechanisms are less likely to be prone to health system corruption. Therefore governments have a responsibility to create sound institutional structures, processes and policies to establish and promote anti-corruption measures to enhance universal health coverage for the population. The brief will assess situations in countries and suggest course of actions to follow in establishing anti-corruption platforms.
[1] World Bank (1997) Helping Countries Combat Corruption: The Role of the World Bank. Washington, DC: World Bank
[2] Omar Azfar and Tugrul Gurgur, ‘Does Corruption Affect Health and Education Outcomes in the Philippines?’, Working Paper (College Park: IRIS Center, University of Maryland College Park, 2004), available at www. iris.umd.edu.
[3] Deon Filmer and Lant Pritchett, ‘Child Mortality and Public Spending on Health: How Much Does Money Matter?’, Policy Research Working Papers, World Bank, 1997; Vinaya Swaroop and Andrew Sunil Rajkumar Swaroop, ‘Public Spending and Outcomes: Does Governance Matter?’, World Bank, Policy Research Working Paper Series, 2002. Lindelow, M., I. Kushnarova and K. Kaiser. 2005. “Measuring Corruption in the Health Sector: What We Can Learn from Public Expenditure Tracking and Service Delivery Surveys in Developing Countries.” Washington D.C.: World Bank