Publication Type: Other
Countries: Nigeria
Authors: SOAS-ACE
Publication date: June 2019
Keywords: Health
What could work to curb health sector corruption and improve health outcomes?
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.
Key Findings
The main types of health sector corruption identified as having a high impact on patient outcomes were absenteeism, under the counter payments to gain access to care, diverting patients to private clinics and informal charges to patients. Absenteeism was identified as the form of corrupt behaviour with the greatest impact on healthcare outcomes. Further research will identify which strategies could best align incentives for healthcare workers to reduce corrupt practice.
Implications
Early findings suggest absenteeism takes two forms: ‘adaptive’ and ‘voluntary’. The first is to cope with health system inefficiencies while the latter is the due to political or social protection and hence identifiable as corrupt behaviour. Our research suggests addressing absenteeism through examining and realigning incentives for healthcare workers could result in the greatest benefits for patients. There could be small interventions that provide phone numbers of personnel on duty rosters so they can be tracked or providing or giving a greater role to local paramount leaders in socially sanctioning absenteeism.
