Corruption in the Health Sector – Causes and Possible Solutions
Corruption is the exploitation of assigned power for personal use. Corruption in the health sector is a concern especially in the developing countries where resources are already limited. There are two categories of corruption: one in which there is a gain of ultimate monetary form and another is non monetary which involves some unethical behavior that doesn’t directly lead to financial gain but some kind of benefit. A number of corrupt activities which are identified in the health sector are illegal fees, unnecessary medical treatment, deception in billing, misuse of powers, bribes for illegal procedures, absenteeism, selling of license to unauthorized person, corruption in pharmaceutical supplies etc.
In Pakistan the health sector is most ignored by misusing the allocated budgets and no maintenance. Muhammad (2011) points out the corruption in the health sector of Pakistan: A cross country survey of the public gauging perceptions of corruption in public service showed that 95% of the study population perceives that the health care system is corrupt in Pakistan. Another survey showed that the frequency of informal payments to public health care providers amongst the users of services is 96% in Pakistan.
Corruption is the devastation of a society. Corrupt societies discontinue honesty or ethical values. Once corruption enters the society it spreads like a web, becomes a part of every activity conducting within the society and is hard to eliminate. It affects each and every member of the society but the poor people are more vulnerable because they don’t have enough money to fill the pockets of authorities therefore their basic needs aren’t fulfilled. It creates hindrance in the development of a country.
Ahmad (2011) stated that “a recent World Bank report lists corruption and lack of transparency as the two core reasons that hamper Pakistan’s drive for development”. Corruption exists in all the countries, in the entire sectors but the health sector is mainly susceptible to it. Hussmann (2010) stated that “Resources spent in the health sectors globally and at country level offer lucrative opportunities for abuse and illicit gain”. The health care sector is prone to corruption because of imbalance of information between health sector providers, uncertainty because failure to predict the upcoming illness, poor functioning of market, low salary, poor governance, lack of clearness and liability, less budget allocated to health sector, no regulation of laws and policies, mismanagement, lack of supervision, lack of connection between pharmaceutical companies and health departments, etc.
There are multiple causes of corruption in health sector. Firstly, there is a lack of good governance. National Corruption Perceptions Survey, Transparency International Pakistan (2010) stated about the causes of corruption that: The most important cause of local government corruption in Pakistan, according to Pakistanis, is a ‘lack of accountability’: comprising 20.76% of total responses given to the question ‘In your opinion, what factors are responsible for corruption in the local government system? Lack of transparency (15.1% of responses) and low salaries (14.56% of responses) are the next most cited reasons.
The government agents use their monopoly power for private gain because it is limiting the choices of the people and increasing the areas for corrupt activities like informal payments. The five groups which are involved in corruption are government regulators, payers, providers, consumers and suppliers. The second cause is the individual personal values, beliefs, and social norms. People after doing corrupt activity tried to justify their behavior through their personal values for e.g. a concept of bribe and gift is taken differently from person to person.
Thirdly, the low socioeconomic public officials are being pressurized to engage in corrupt activities. The corruption in the health sectors will have many consequences. For instance, failure to achieve millennium developmental goals, great impact on the equity, effectiveness and accessibility of health care services, less investments in the health sector by foreign investors, increase cost of services, more focus on infrastructure rather than primary care like immunization, impact on the health of the people. Moreover those who are unskilled and poor will get poor health care services or ineffective treatment.
Muhammad (2010) stated about the impact of corruption on health. His report mentions a number of horrendous issues: pregnant women have been refused care because they were HIV positive, hospital authorities have refused to release the bodies of patients who died in their care because the relatives could not afford to pay the medical bills.
The corruption in the health sectors can be lessened if government becomes accountable and provides less opportunity for corrupt activities to occur by eliminating monopoly and discretion. There should be a proper legal institution working against all kinds of corrupt activities and it shouldn’t be linked with the government. Developing countries should organize their health financing strategies for the availability of funds. Moreover, there should be proper use of allocated budget.
The government should focus on transparency in drug regulation systems. There should be a link between health department and drug industry to have proper knowledge. People should be allowed to choose their health service by themselves.
Corruption is affecting each and every member of a society by one way or another. Health has now become a global industry where exploitation of human rights and making people deprived of access to health care is very common. So as a member of this society and a nurse I would report those incidences of corruption to higher authorities, refuse to pay and accept bribes, make some polices in which there would be zero tolerance against corruption. I would recommend that the ethical and moral values of individual personnel should be strengthened.
All people of the society or a nation should take steps to fight against the corruption. Corruption is occurring at all levels although we won’t be able to wipe out this activity from its root but still we can take steps to wage a war against corruption.
1. Ahmed AS. Impact of corruption on our society. 2011. Available from:, The Nations Web site: http:// http://www.nation.com.pk/pakistan-news-newspaper-daily-english-online/Opinions/Columns/16-Aug-2011/Impact-of-corruption-on-our-society.
2. Haque HA. Corruption in the government hospitals. International Journal of Pathology. 2010;8(2)
3. Hussmann HK. Addressing corruption in the health sector. Department for International Development. 2010.
4. Huge corruption in sindh health department. 2009 http://http://iaoj.wordpress.com/2009/03/28/huge-corruption-in-sindh-health- department/
5. Fighting corruption worldwide. Transparency International UK. Retrieved from
6. Muhammad MA. Corruption in medical practice: how far have we gone? Journal of Pakistan Medical Association. 2011;61(1)
7. Corruption in the health sector. (2008). Anticorruption Resource Centre, (10), 3-84.
8. Sachal M. Child healthcare and corruption. Dawn.com. 2011 http://http://www.dawn.com/2011/04/13/child-healthcare-and-corruption.html
9. Shah SA. Corruption.Global Issues Social, Political, Economic and Environmental Issues That Affect Us All, 2011. http://http://www.globalissues.org/article/590/corruption.
10. Vian VJ. Review of corruption in the health sector: theory, method and intervention. Health Policy and Planning. 2007;23.
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