Advice on fighting healthcare corruption – UN Report

The United Nations Development Programme published a report on methods, tools and good practices for fighting corruption. The full report can be found by clicking Anticorruption-Methods-and-Tools-in-Health-final.

The report found 10 lessons were critical for fighting corruption:

Lesson one. There is no ‘one size fits all’ approach to mitigating corruption in the health sector. Practitioners need to give careful attention as to what potential strategy or strategies would work most effectively in view of the specific risks identified by use of diagnostics.
Lesson two. More than one anti-corruption intervention should be employed to deal with one risk. For example, wage increases may help to curb the likelihood of absenteeism, but they are likely to be more effective when there are systems in place to document absentee rates and when sanctions for absence are imposed.
Lesson three. Prioritization is key: governments and others involved in health projects and programming should prioritize areas of the health system that are most susceptible to corruption and implement appropriate interventions. Often even ‘low hanging fruit’ can produce significant anti-corruption impacts. For example, the act of posting medical supply and pharmaceutical product pricing can help deter price gouging. The identification of priority areas is particularly important when resources are scare.
Lesson four. It is important to work with other sectors. Corruption cannot be curbed in the health sector without the involvement of other critical sectors, such as infrastructure and finance.
Lesson five. Health policy goals should include anti-corruption considerations. Investments in health may be wasted unless anti-corruption strategies are built into all health projects. Preventative interventions can protect investments made.
Lesson six. Prevention is the best strategy: therefore, it is best not to wait for corruption to happen before beginning to deal with it. One of the biggest failings in the health sector is the implementation of anti-corruption interventions only after corruption is suspected or confirmed. Regular monitoring of the health sector for discrepancies in standards is vital.
Lesson seven. Numerous empirical diagnostic tools should be employed. Given the complexity of the health sector, more than one diagnostic tool may be of value to ensure accurate information. This also requires proper measuring and re-measuring. Regular ‘check-ups’ can measure how effectively anti-corruption strategies are working in a given point in the health care system.
Lesson eight. Partners with experience in implementing anti-corruption strategies and tactics should be identified and contacted for technical support. This study has identified a number of NGOs, international development institutions, research groups and experts involved in implementing anti- corruption strategies and tactics in the health sector.
Lesson nine. Broad participation in health policy and planning helps. Involving NGOs, citizens and designated experts in health budgeting, monitoring, and consulting, as a few examples, can help heighten transparency and lessen the likelihood of corruption.
Lesson ten. Good behaviour should be rewarded, and bad behaviour punished. This can be done by setting up appropriate incentive structures that help promote adherence to good behaviour, such as performance-based financing. It is also important to sanction those individuals who are engaged in corrupt activities where possible. This sends an important message that corruption is not tolerated.

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