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U4 ISSUE January 2011 No 1

Addressing corruption in the health sector

Securing equitable access to health care for everyone Karen Hussmann AntiCorruption Resource Centre www.U4.no

U4 is a web-based resource centre for development practitioners who wish to effectively address corruption challenges in their work. U4 is operated by the Chr. Michelsen Institute (CMI) – an independent centre for research on international development and policy – and is funded by AusAID (Australia), BTC (Belgium), CIDA (Canada), DFID (UK), GTZ/BMZ (Germany), Norad (Norway), Sida (Sweden) and The Netherlands Ministry of Foreign Affairs. All views expressed in this Issue are those of the author(s), and do not necessarily reflect the opinions of the U4 Partner Agencies or CMI/ U4. (Copyright 2011 - CMI/U4)

Addressing corruption in the health sector Securing equitable access to health care for everyone

By Karen Hussmann

U4 Issue January 2011 No 1

This U4 Issue is an adaptation of a 2010 DFID-funded practice paper (How to note)

Contents 1.

Introduction: why should donor agencies care about corruption in the health sector? ................... 5 1.1.

2.

Why is the health sector particularly susceptible to corruption? .........................................................5 What is corruption and how does it manifest itself in the health sector? ........................................... 6

2.1.

How does corruption manifest itself in the health sector? ..................................................................... 7

3.

Framework to understand and mitigate corruption in the health sector ............................................. 8

4.

What are the main risks to corruption and selected mitigating strategies in the health sector? 10

5.

What are the main tools to identify, track and measure corruption? .................................................. 13

6.

How to integrate anti-corruption strategies into health policies/plans? .......................................... 15 6.1. Integrate corruption diagnostic(s) and mitigating strategies into health systems development using the WHO model .............................................................................................................................. 17 6.2. Develop accountability, transparency, integrity strategy for the health sector ..........................18 6.3. Ensure that the national development/poverty reduction strategies include corruption diagnostics and mitigating strategies..........................................................................................................................19 6.4. Use opportunities for targeted reforms or measures .............................................................................19 6.5. Introduce a focus on corruption in health into government-donor dialogue ..................................19 6.6. Foster external monitoring and oversight ................................................................................................... 20 6.7. What is the right moment to initiate anti-corruption initiatives in health? ................................... 20 6.8. Promote cooperation between health and governance teams / advisors within donor agencies .................................................................................................................................................................................... 21

7.

Relevant links ....................................................................................................................................................... 23

8.

Selected Bibliography ........................................................................................................................................ 23

9.

Annexes