Access to health care can mean the difference between life and death. Yet, the health sector isn’t immune to corruption. Indeed, the new U.S. Strategy on Countering Corruption is clear that the issue of corruption cuts across all sectors.
In recent blogs, we explored the history of integrated governance and factors to use when selecting, designing, and implementing such programs. Now, we turn our attention to what integrated governance approaches look like in practice in the health care sector.
In this post, we explore how the Governance, Accountability, Participation and Performance (GAPP) project, co-funded by USAID and UKAID/FCDO, integrated an anti-corruption approach to improve health services. By examining the consequences of corruption on health outcomes, factors that led to this program’s success, and lessons learned, we gain insight into how we can move forward together as a development community to reduce health care corruption more effectively.
Defining the Problem: Corruption in the Health Sector
Health care corruption robs citizens of equal access to vital services, including denying them the right to quality health care. Corruption affects all dimensions of health care, from access to equity and efficacy. Each year, globally, more than $500 billion in health spending each year is lost to corruption and fraud – a particularly significant issue as COVID-19 stresses already-tight national health budgets.
The consequences of corruption in the health sector are literally life threatening. Child mortality is correlated more strongly with national corruption levels than with literacy, access to clean water, and even vaccination rates.
In Uganda, a 2018 study found that high-profile corruption scandals; underfunding that led to scarcity of services, drugs, and supplies; and low salaries for staff created conditions ripe for bribery. The country’s Health Monitoring Unit also noted that lack of costing standards for construction, lax procurement procedures and oversight, and weak accountability for inventory and vehicles were also problems that increased the risks of corruption.