Health sector corruption is endemic in Nigeria’s health setting and has stalled the progress of key health indicators in the country, including Universal Health Coverage. The project seeks to identify and understand corruption and its flashpoints in the health sector, produce and harness evidence for solution, and push for incremental change
Partners on the project draw from the School of Oriental and African Studies, London; London School of Hygiene and Tropical Medicine, and funded by the UK Aid – Department for International Development (DFID).
Systematic review on health sector corruption published as a technical report (https://ace.soas.ac.uk/wp-content/uploads/2018/09/Corruption-in-the-health-sector-in-Anglophone-W-Africa_ACE-Working-Paper-005.pdf) and as a paper (https://academic.oup.com/heapol/article/34/7/529/5543565)
Nigeria and Malawi (the subjects of this study) both have high levels of corruption: Transparency International’s corruption perception index ranks them 120th and 144th out of 180 respectively. In the public health systems weak accountability and corruption are major barriers to the achievement of universal health coverage (UHC) and the delivery of effective care. Focusing on frontline staff in these two countries, our aim is to find feasible, high-impact strategies to strengthen governance in order to tackle corruption and poor accountability. To do this we will focus on the reasons why both persist and to find areas where interests of key actors coincide to allow change.
This research will seek to understand how the positionality of actors and the incentives that they face within formal and informal structures (inside and outside the health system) impact on strategies to mitigate corrupt practice and improve accountability, both individual and collective.
While Nigeria and Malawi are in different regions of Africa their health systems have important similarities, with decentralisation to subnational authorities that hold considerable power to plan and manage services (districts in Malawi and states/Local Government Authorities (LGAs) in Nigeria) which make them useful for comparative studies. Our hypothesis is that a detailed understanding of the intersections between formal and informal structures, incentives and networks at the district level will inform the design of contextually appropriate interventions that are most likely to be able to tackle corruption, strengthen accountability, and enable the achievement of UHC.
