Health Providers in Nigeria

What could work to curb health sector corruption and improve health outcomes?

Download the research summary.

Research question:

Corruption is common across different levels of the health sector in Nigeria, and a major barrier to achieving universal health coverage. This project seeks to identify the most common and damaging forms of corruption, establish why they occur, and to assess a range of approaches to help reduce corruption in healthcare delivery and its impacts on health outcomes for Nigerian citizens.

Project summary:

Achieving the Sustainable Development Goal 3 of Universal Health Coverage is hampered in many countries by widespread health sector corruption. This project aims 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 will synthesize available evidence on the impact of corruption on users of health services and identify and assess the potential of accountability measures, including recent reforms, to constrain corrupt practices among frontline public health providers and their managers. Finally, it will make 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. Further recommendations on the most effective ways to work with health workers to address absenteeism will follow.

Team members: 

Pallavi Roy (SOAS University of London), Obinna Onwujekwe (University of Nigeria Nsukka), Dina Balabanova and Eleanor Hutchinson (LSHTM), Prince Agwu, Aloysius Odii, Pamela Ogbozor and Charles Orjiakor (University of Nigeria Nsukka).

Read the full research summary.

Other projects

Fertilisers in Nigeria

This project will examine centralised and technology-enhanced distribution modalities that have recently been introduced into fertiliser subsidy programmes in Nigeria and Tanzania - two of the largest...

Read more

Extractives in Nigeria

Analysis suggests systemic reform will be difficult to achieve in extractives in Nigeria given the distribution of power. Our approach will be to collect data and map the interdependent network of pol...

Read more

Bribery Game in Nigeria

In Lagos, we will conduct a household level survey experiment using an embedded bribery game. Participants of the survey will be randomly assigned to a control group, or to one of several condition gr...

Read more

Business Groups in Nigeria

This cross-country project will trace the evolution of such local firms and analyse their impact on growth in their respective sectors. It will attempt to isolate proactive policy from their experienc...

Read more

Power in Nigeria

This cross-country project will trace the evolution of such local firms and analyse their impact on growth in their respective sectors. It will attempt to isolate proactive policy from their experienc...

Read more

Media, elections and corruption

The media sector in Nigeria is a vibrant platform for political opinion and debate. But how does media reporting reflect, interact with and impact on corruption and anti-corruption in Nigeria, particu...

Read more