Abstract
Abstract
Background
The dynamic intersection of a pluralistic health system, large informal sector, and poor regulatory environment have provided conditions favourable for ‘corruption’ in the LMICs of south and south-east Asia region. ‘Corruption’ works to undermine the UHC goals of achieving equity, quality, and responsiveness including financial protection, especially while delivering frontline health care services. This scoping review examines current situation regarding health sector corruption at frontlines of service delivery in this region, related policy perspectives, and alternative strategies currently being tested to address this pervasive phenomenon.
Methods
A scoping review following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) was conducted, using three search engines i.e., PubMed, SCOPUS and Google Scholar. A total of 15 articles and documents on corruption and 18 on governance were selected for analysis. A PRISMA extension for Scoping Reviews (PRISMA-ScR) checklist was filled-in to complete this report. Data were extracted using a pre-designed template and analysed by ‘mixed studies review’ method.
Results
Common types of corruption like informal payments, bribery and absenteeism identified in the review have largely financial factors as the underlying cause. Poor salary and benefits, poor incentives and motivation, and poor governance have a damaging impact on health outcomes and the quality of health care services. These result in high out-of-pocket expenditure, erosion of trust in the system, and reduced service utilization. Implementing regulations remain constrained not only due to lack of institutional capacity but also political commitment. Lack of good governance encourage frontline health care providers to bend the rules of law and make centrally designed anti-corruption measures largely in-effective. Alternatively, a few bottom-up community-engaged interventions have been tested showing promising results. The challenge is to scale up the successful ones for measurable impact.
Conclusions
Corruption and lack of good governance in these countries undermine the delivery of quality essential health care services in an equitable manner, make it costly for the poor and disadvantaged, and results in poor health outcomes. Traditional measures to combat corruption have largely been ineffective, necessitating the need for innovative thinking if UHC is to be achieved by 2030.
Funder
Department for International Development, UK Government
DfID
Publisher
Springer Science and Business Media LLC
Subject
Public Health, Environmental and Occupational Health
Reference85 articles.
1. Hogan DR, Stevens GA, Hosseinpoor AR, Boerma T. Monitoring universal health coverage within the sustainable development goals: development and baseline data for an index of essential health services. Lancet Glob Health. 2018;6(2):152–68..
2. Kutzin J, Sparkes SP. Health systems strengthening, universal health coverage, health security and resilience. Bull World Health Org. 2016;94(1):2.
3. Lewis M. Governance and corruption in public health care systems. Center for Global Development Working Paper No. 78. https://www.cgdev.org/sites/default/files/5967_file_WP_78.pdf. Accessed 24 Feb 2020.
4. Evans T, Whitehead M, Diderichsen F, editors. Challenging inequities in health: from ethics to action. New York: Oxford University Press; 2001.
5. Vian T. Review of corruption in the health sector: theory, methods and interventions. Health Policy Plan. 2008;23(2):83–94.
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