UNDP'S ONLINE COURSE ON ANTI-CORRUPTION IN THE HEALTH SECTOR

There is limited access to information (e.g. consumers/patients’ rights, service delivery standards, official price schedules, procurement information) for all stakeholders. There is an imbalance in the availability of information between stakeholders.

The country has a weak control and audit systems (internal and external), e.g. through bodies such as Supreme Audit Institutes, inspectors, notified bodies and ombudsmen. The country has inefficient or weak appeal mechanisms in place.

Limited or no involvement of consumers/community groups in the design and delivery of public services. There is limited or no engagement of civil society in the oversight of policy and services

There is a ‘high’ tolerance towards various forms of corruption in the country. In general, there is low awareness of corruption and its many forms. There is no clear definition of corruption. The country’s social structure accepts nepotism/favoritism, such as among family members.

• There are no or weak special measures to prevent and detect corruption;
• The government has no or a weak anti-corruption program in place;
• Codes of Conduct/Codes of Ethics are non-existent or weak;
• The is inconsistent legislation, both within and between countries (loopholes).

• Healthcare providers salaries are low and/or irregular.
• Healthcare providers are not paid fee-for-service (salary based).
• The number of public providers is relatively high resulting in difficulties to monitoring (e.g. in remote areas).

• There are scarce resources (healthcare professionals, drugs, medical devices)and public spending on healthcare is relatively low.
• Out of pocket payments are relatively high (i.e. patients pay for healthcare consumed).
• The healthcare system is tax-based, potentially providing opportunities for abuse or diversion of public funds.

• There is a high level of decentralization.
• There are most often a small number of providers participating in the procurement process.
• Drugs are actively promoted to physicians.
• There are  a variety of purchasing methods (restricted tenders, quotation-based methods, direct ordering).
• There are only a few medical supplies providers (market power).