What do Youth Think about Corruption in the Health Sector?

Dr. Reshma Trasi, Monitoring, Evaluation, and Research Team Director, LMG

Meghan Guida, Monitoring and Evaluation Specialist, LMG

LMG presented a poster at the Third Global Symposium on Health Systems Research on the results from analysis of an online survey on corruption. In July 2013, The Leadership, Management & Governance Project (LMG) conducted an online survey of health managers and leaders to assess their perceptions of corruption in the health sector, and received 1,076 responses from 95 countries. Questions asked respondents about their perceptions of areas vulnerable to corruption; factors that contribute to corruption; institutions’ and individuals’ effectiveness at reducing corruption; the extent to which organizations and individuals are engaged in reducing corruption; and the impact of interventions on reducing corruption. Likert scale question responses were disaggregated by age group: <30 years, 30-45 years, 46-60 years, and >60 years.

Source: Corruption in the Health Sector: An analysis of health leaders’ and managers’ perceptions of corruption by age. Authors: Mariah Boyd-Boffa, MPH1, Angela Lee, MPH1, Reshma Trasi, MBBS, MHA, MPH2 Affiliations: 1Management Sciences for Health, Medford, Massachusetts USA, 2Management Sciences for Health, Arlington, Virginia USA

Among the statistically significant findings, fewer younger respondents (<30 years) ranked a given set of factors as “highly important” in contributing to corruption compared with older respondents (>60 years). Factors included, for example: provision of services, procurement, construction, human resource management systems, budget management systems, and prescribing and dispensing drugs.

Older respondents have a less encouraging, but perhaps more realistic, view, possibly due to their longer exposure to health sector corruption; they are more likely to perceive that the aforementioned factors contribute to corruption. Of particular interest is the difference between younger and older respondents’ views on the importance of societal acceptance of corruption as normal, and views on the lack of ethical/moral integrity among health workers. As such, applying diverse anti-corruption measures across different age groups may be most effective in stemming corruption.

If corruption is a learned behavior, engaging youth in leadership development activities and encouraging values such as transparency and accountability could help change corruption’s status as a norm over time as youth rise in the ranks of health sector leadership, management, and governance positions.

The poster presentation of these results at the Third Global Symposium on Health Systems Research drew a lot of interest. Attendees were interested in how corruption was defined in the survey and how or who decides if a practice is corrupt, given different cultural and contextual perspectives at play. At the same time, there were several people who acknowledged the importance of addressing grand-scale corruption (e.g., in procurement of medicines) if we want funds to result in providing adequate and high-quality services to communities. Others reinforced the need to work with youth and the underexplored opportunity of technology in addressing corruption, such as through the use of mobile applications for reporting corrupt practices.

Almost one-fifth of the world’s population is between 15 and 24 years old and the majority live in developing countries. Among these youth are future health sector leaders and managers, whose relatively positive outlook on the capacity to mitigate corruption should be harnessed. Making progress against health sector corruption must involve the active participation and leadership of young people.