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

PROGRESS

General corruption risk approaches applicable to the health sector Overview of actors

(4) Tools  for measuring Corruption (Vian 2008a: 88-90)

Table 2. Measuring corruption: data collection and analysis

Approach Description Benefits Weaknesses
Corruption perception surveys  Surveys of perceptions about corruption, citizens in general, or particular classes of health workers. Examples: World Bank Corruption Perception Surveys, Transparency International´s Corruption Perception Index, Freedom House´s Freedom in the World Survey 
  • Highlights areas of cocern
  • Establishes baseline and allows monitoring of changes over time
  • Asking different health workers about the same problem can illuminate issues 
  • Provides Public information for external accountability 
  • Current debate on best methodology, and how results may be affected by local understanding of terms
  • Perceived behaviour may differ from actual behaviour
Household and public expenditure surveys  Household surveys measure expenditures including health care and informal payments. Public expenditure analysis can identify leakages n flows of public funds between levels of government. Examples: World Bank Living Satandards Measurement Surveys; Public Expenditure Tracking Surveys 
  • Provides detail on household health spending by income and region, formal or informal
  • Data can be compared with goals to provide measures of accountability, e.g. amounts paid for allegedly free services, percentage of government spending actually reaching service delivery points.
  • Existing data sets may not have asked questions in ways that allow one to distinguish between formal and informal payments
  • Public expenditure tracking surveys depend on public records, which may be patchy 
Qualitative data collection  Qualitative data collection through in-depth interviews and focus groups, to determine areas of concern. Example: Vian et al, (2006); Balabanova and Mckee (2002 a,b)
  • Provide details on attitudes, norms, beliefs, presures
  • Helps to define terms, clarify the ‘how‘ of corrupt acts, inform development of perceptions surveys 
  • Allows fllow-up
  • Social desirability bias or reticence may influence results
  • To get full cross-cultural meaning requires careful attention to translation and training of research staff
Control systems review Examines inherent risks given mission/mode of operation; control environment; and existing safeguards against corruption. Examples: US Office of Management and Budget internal control guidelines (Klitgaard 1988, p. 84-85), US hospital compliance programmes to combat fraud (OIG 1998); pharmaceutical assessment (WHO 2007)
  • Good for comparing actual systems with best practice 
  • Provides deep analysis of particular government departments or units 
  • Assumes systems are stable, therefore not good for systems undergoing health reform
  • Works better in countries with developed administrative systems and good documentation

Table. Measuring corruption: data collection and analysis
Source: Vian 2008a: 88-90