Study on the Extent and Costs of Corruption in the Health Sector in Uganda

Fazekas, Mihály; Adam, Isabelle; Nikulina, Olena; Dina Balabanova; Dávid-Barrett, Elizabeth; Hutchinson, Eleanor; Kirya, Monica; and Peiffer, Caryn (2021) Study on the Extent and Costs of Corruption in the Health Sector in Uganda. Inspectorate of Government, Uganda, Kampala.

The overall objective of the study is to generate empirical data on the cost and extent of corruption in the Health Sector Uganda that can be used for dialogue with stakeholders to inform anti-corruption policy formulation, strategies, and programs in the sector. The baseline study shall provide a basis to understand and measure if an enhanced focus to curb corruption in the Health sector will have a positive impact over an extended period. The study will help to identify why citizens pay bribes to get services, but also why the health workers and staff in the Health sector asks for bribes.

In the Ugandan Health System, corruption hinders access to vital services, worsening poverty and increasing inequality. Access to essential services across the country is often dependent on the ability to pay a bribe to the public servants who act as informal gatekeepers. Despite the knowledge that corruption is widespread and undermines the goals of the health sector, the development of anti-corruption policy has been challenged by a lack of data on the overall cost of corruption in healthcare in the country. To address this gap in knowledge, this report provides a detailed estimate of the extent and costs of corruption in the healthcare sector in Uganda for 2019, the study differentiates between direct and indirect costs. The first group includes that which can be directly attributed to corrupt acts, while the second group includes all those that result from corrupt acts through a series of interactions on the longer term. The study also attributes the costs of corruption to different cost bearers: citizens and firms, public budget, or society at large.

The findings are based on a review of the literature, a nationally representative household survey of users of healthcare services, and in-depth interviews with practitioners and experts in the sector. Alongside this qualitative and quantitative primary data collected to develop this report, the study also drew on administrative data, and secondary survey data (the East Africa Bribery Index and National Integrity Survey).

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