We Need to Measure & Address Corruption & Poor Governance in Health Systems

Aceso Global CEO Maureen Lewis published a response to a recent article by Hutchinson et al., "We need to talk about corruption in health systems," in the International Journal of Health Policy and Management. In her response, she agrees with the authors’ argument regarding the need for greater attention to and work in corruption in health systems globally. She then lays out some of the rationale for how to define the pertinent research questions and how best to address corruption — arguing that governance rather than corruption may offer a preferred starting point. She concludes by highlighting options for measuring, analyzing and stemming corruption in healthcare.


Combating Corruption in Global Health

In the past 20 years, the international community has begun to fully recognize the devastating effect of corruption on global health. Poor governance, marked by weak institutions, absence of rule of law, and lax enforcement of health policy, creates conditions for corruption to thrive. This can contribute to health system failure and deprive citizens of access to even basic health services. This paper explores the extent of corruption in health services, as well as  emerging anti-corruption tools and inter-agency frameworks that could prove effective in limiting corruption in global health. While corruption has gained attention in the international sphere, more action is needed in the specific context of global health. This paper was co-written by Maureen Lewis (CEO of Aceso Global), Tim K. Mackey, Jillian Kohler and Taryn Vian.


Who is Paying for Health Care in Eastern Europe and Central Asia?

This paper analyzes informal payments in Eastern European and Central Asian (ECA) public healthcare systems. Informal payments comprise any purchase of health services outside of formal payment channels and therefore escape reporting and regulation measures. These payments, which are highly prevalent across the region, impede access, decrease equity and ferment systemic corruption. As a result, patients either consume less health care or sell personal assets to pay for treatment. This paper highlights the policy implications of informal payments and explores potential solutions to this problem.


Governance and Corruption in Public Health Care Systems

This paper examines the relationship between governance and health care delivery, defines indicators for governance and corruption, and summarizes country and cross-country evidence using these indicators. The components of governance and corruption examined include perceptions of corruption and performance, management challenges in public health systems, staff absenteeism, informal payments, and misuse of public funds. Concluding that governance plays an important role in the performance of health services, this paper provides policy options for promoting better governance.