Health Providers in Nigeria

Achieving the Sustainable Development Goal 3 of Universal Health Coverage is hampered in many countries by widespread health sector corruption. This project aimed to identify the patterns of corruption among frontline public health providers and their managers in Nigeria, and explore the underlying determinants – systemic and individual factors – that give rise to corrupt behaviours.

It synthesised available evidence on the impact of corruption on users of health services and identified and assessed the potential of accountability measures, including recent reforms, to constrain corrupt practices among frontline public health providers and their managers. Finally, it made recommendations towards a more resilient, efficient and accountable health system.

The project methodology uses a scoping literature review, policy analysis, qualitative study, survey of up to 400 providers including discrete choice experiment (DCE) and open-ended vignettes methods to understand the choices made by health providers, given a series of hypothetical anti-corruption strategies.

From the literature review and workshops with health providers and policy makers, we found that absenteeism, diversion of patients to private clinics, inappropriate prescribing, informal payments/bribery and theft of drugs and supplies were the top five corruption problems in the health sector.

In addition, absenteeism was identified as the most prevalent type of corruption, as well as the type of corruption that was most feasible to address: to improve healthcare outcomes, policy-makers could therefore focus first on strategies to address absenteeism, particularly in rural areas.

SOAS-ACE is currently undertaking research in Bangladesh and Nigeria, including in the education, health and power sectors, as well as on successful collective action that overthrew a corrupt autocracy. Moving beyond pure research, we are also monitoring the implementation of anti-corruption strategies our research has recommended, such as a strategy to reduce pharmaceutical companies’ overpricing of medicines.