Corruption in Anglophone West Africa health systems

A systematic review of its different variants and the factors that sustain them

Dados Bibliográficos

ID14668342
AutoresObinna Onwujekwe (0000-0002-1214-4285, University of Nigeria), Prince Agwu (0000-0001-9224-7622, University of Nigeria), Charles Orjiakor (University of Nigeria), Martin Mckee (0000-0002-0121-9683, Department of Global Health and Development, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, UK), Eleanor Hutchinson (0000-0002-9718-2407, Department of Global Health and Development, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, UK), Chinyere Mbachu (0000-0003-3936-6184, University of Nigeria), Aloysius Odii (0000-0002-2222-0835, University of Nigeria), Pamela Ogbozor (0000-0003-1343-1822, University of Nigeria), Uche Obi (0000-0003-0684-2455, University of Nigeria), Hyacinth Ichoku (University of Nigeria), Dina Balabanova (0000-0001-7163-3428, Department of Global Health and Development, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, UK)
Ano2019
Volume34
Fascículo7
Páginas529-543
Data de publicação2019-09-01
Peer ReviewedSim
Open AccessSim
TipoARTICLE
PeriódicoHealth Policy and Planning (JOURNAL)
Identificadores do periódicoISSN: 0268-1080 • E-ISSN: 1460-2237
EditoraOxford University Press (OUP) (PUBLISHER)
DOI10.1093/heapol/czz070
IdiomaEN
Citações recebidas35
Referências citadas20

West African countries are ranked especially low in global corruption perception indexes. The health sector is often singled out for particular concern given the role of corruption in hampering access to, and utilization of health services, representing a major barrier to progress to universal health coverage and to achieving the health-related Sustainable Development Goals. The first step in tackling corruption systematically is to understand its scale and nature. We present a systematic review of literature that explores corruption involving front-line healthcare providers, their managers and other stakeholders in health sectors in the five Anglophone West African (AWA) countries: Gambia, Ghana, Liberia, Nigeria and Sierra Leone, identifying motivators and drivers of corrupt practices and interventions that have been adopted or proposed. Boolean operators were adopted to optimize search outputs and identify relevant studies. Both grey and published literature were identified from Research Gate, Yahoo, Google Scholar, Google and PubMed, and reviewed and synthesized around key domains, with 61 publications meeting our inclusion criteria. The top five most prevalent/frequently reported corrupt practices were (1) absenteeism; (2) diversion of patients to private facilities; (3) inappropriate procurement; (4) informal payments; and (5) theft of drugs and supplies. Incentives for corrupt practices and other manifestations of corruption in the AWA health sector were also highlighted, while poor working conditions and low wages fuel malpractice. Primary research on anti-corruption strategies in health sectors in AWA remains scarce, with recommendations to curb corrupt practices often drawn from personal views and experience rather that of rigorous studies. We argue that a nuanced understanding of all types of corruption and their impacts is an important precondition to designing viable contextually appropriate anti-corruption strategies. It is a particular challenge to identify and tackle corruption in settings where formal rules are fluid or insufficiently enforced