Bribery in health care in Uganda

Analyzing Markets for Health Workers: Insights from Labor and Health Economics

“…This finding needs to be interpreted with some caution, however, as the study assumes that all differences between expenditures reported by consumers and providers are informal charges, whereas other explanations, such as a tendency to overstate expenditure by consumers, might apply. Hunt (2010) finds that informal charges have reemerged in the postformal user-charge situation of Uganda and identifies the existence of informal charges in the private sector too, although at slightly lower levels than in the public sector. However, in the analysis of this paper, private sector "bribes" appear to be predominantly payments by those suffering from respiratory or sexually transmitted diseases, who, according to official policy, should be exempted in the private not-for-profit sector, if they fail to be offered official exemption.…”

“…Gaal, Evetovits, and McKee (2006); Onwujekwe et al (2010);and Hunt (2010) analyze the processes of informal payments in Hungary, Nigeria, and Uganda, respectively. Gaal, Evetovits, and McKee (2006) estimate informal payments in Hungary at 1.5-4.6% of total health expenditure, suggesting a minor role as a source of finance.…”

Who bears the burden of bribery? Evidence from public service delivery in Kenya

“…By offering speed money, they either access services they are not entitled to or provide “the much‐needed grease for the squeaking wheels of a rigid administration” (Bardhan, , p. 1322) and thus reallocate their resources to high productive activities. At the empirical level, Hunt and Laszlo () found that rich individuals are four times more likely to pay bribes in Peru while Hunt () found that rich individuals are 1.2 percentage points more likely to pay bribes to access health services in Uganda. Hunt and Laszlo () found that rich individuals in Uganda absorb the cost of bribery in order to avoid deliberate delays in processing documents while Meon and Weill () found evidence in support of the “grease the wheels” hypothesis in a cross‐country analysis of developing countries and that corruption is less detrimental to efficiency where institutions are ineffective.…”

Contextualizing Corruption in the Health Sector in Developing Countries: Reflections on Policy to Manage the Risks

“…Some of the types of corruption in the health sector (see, for example, Balabanova & McKee, ; Ensor, ; European Commission, ; Gaal, Belli, McKee, & Szócksa, ; Gauthier & Wane, ; Hunt, ; Lewis, ; Liu & Sun, ; Mackey & Liang, ; Maestad & Mwisongo, ; Mostert, Sitaresmi, Njuguna, van Beers, & Kaspers, ; Popović, ; Stepurko, Pavlova, Gryga, Murauskiene, & Groot, ; Stringhini, Thomas, Bidwell, Mtui, & Mwisongo, ; UNDP, , ; Vian, ) include the following: Theft for personal use or diversion of public drugs to private clinics by health workers; Sale of drugs or supplies to patients that are supposed to be free; Diversion of public medical equipment to private clinics; Short working hours of health workers due to absenteeism and tardiness; Poor handling of patients, especially the vulnerable groups such as the elderly and expectant mothers; Bribes/informal payments in return for quick service delivery; Bribes to speed up the process or gain approval for drug registration, drug quality inspection, or certification of good manufacturing practices; Biased application of accreditation, certification, or licensing procedures and standards; Embezzlement or fraud related to health‐care funds; Collusion in the procurement process for drugs, medical supplies, medical equipment, and construction and rehabilitation of health facilities; Use of public facilities and equipment to see private patients; Unnecessary referrals to private practice or privately owned ancillary services; Absenteeism; Informal payments required from patients for services; and Theft of user fee revenue, other diversion of budget allocations. …”