Anti-Corruption Approaches in Health Programmes

Anti-Corruption Approaches in Health Programmes

Increased transparency and accountability in the Health Sector and Global Fund Programmes 

Greater transparency and accountability in the health sector and Global Fund Programmes would reduce the risk and help prevent embezzlement and fraud at the same time increasing performance of Global Fund investments and the health sector broadly. Thus, transparency and accountability initiatives have to include a part of strengthening national health system to deliver quality services.

Transparency refers to the sharing information and acting in an open manner. Processes, institutions, and information are directly accessible to those concerned with them, and enough information is provided to understand and monitor them. (UNDP 1997). 

Accountability refers to the refers to the act of holding public officials/service providers answerable for processes and outcomes and imposing sanctions if specified outputs and outcomes are not delivered . The result of the process which ensures that health actors take responsibility of what they are obliged to do and are made answerable for their actions (WHO, 2011).

UNDP approaches to support enhancing transparency and accountability:

1. Transparency and accountability integrated as part of the assessment and capacity development planning to assess whether there are enough safeguards to prevent corruption;

  1. Whether there exists strong internal monitoring and control mechanisms to prevent systemic embezzlement and misappropriation of funds and other fraudulent activities
  2. To identify if there are strong mechanisms for enforcing ethics, code of conducts and dealing with conflict of interest in systems for health and Global Fund grants
  3. To determine if there are effective internal and external oversight mechanisms (e.g., civil society mechanism, multi-stakeholder mechanism and monitoring by the national anti-corruption agencies)
  4. Whether there are effective corruption reporting mechanism including whistle-blower mechanisms and the mechanisms that protects the whistle blowers.
  5. If there are adequate systems for information discloser to the public
  6. Whether the online payment systems are effective
  7. Whether there are any gaps in the web-based reporting mechanisms

2. Providing advisory support on transparency and accountability to the Ministry of Health, Stakeholders and Global Fund Programmes;

  1. Facilitation of a quick transparency and accountability scan and production of a prioritized action plan for the Health Sector and Global Fund programmes
  2. Technical Assistance to support the strengthening of effective national, state and local level multi-stakeholder oversight and monitoring mechanisms (e.g., watchdog groups involving key populations, citizens, government and private sectors)
  3. Advisory support to link the Global Fund related monitoring and investigation to an Independent Corruption Commission
  4. Support to develop or improve and introduce systems and SOPs to better track funds, supplies and payments (including the effectiveness of online systems that collects all documents for payment in real time)
  5. Depending on the need support can be provided for the more specific prevention of embezzlement and fraud including;
    • Strengthening internal control and institutional check and balance (e.g., divisions of functions between cashiers and accountants, etc.)
    • The system to compare the actual and expected expenditures to prevent fraud
    • Periodic internal and external review and audits
    • Anonymous corruption reporting systems such as hotline or online systems and protecting the whistleblowers
    • Effective investigation and prosecution or administrative sanctions for individual breaches
    • Enforcing ethics and code of conduct for health officials and Global Fund programme staff, consultants and contractors
    • Effective screening and background checks of potential employees and consultants
    • Frequent monitoring of expenditures and documents summited for the payments 

3. To provide advocacy, awareness, orientation and training activities to

  1. Produce Corruption risk assessment guide and train major stakeholders on how to prevent embezzlement and fraud
  2. Organize highly visible awareness raising activities on corruption to all major stakeholders at national and sub-national levels
  3. Design and deliver ethics training to Health Sector and Global Fund programme staff
  4. Design and roll out an advocacy campaign particularly targeting the corruption in the health sector

UNDP Experience of Strengthening Transparency and Accountability:

  1. UNDP has been working in many countries around the world on mitigating corruption risks in the health sector. In 2011, UNDP produced a Guide “Fighting Corruption in the Health Sector: Methods, Tools and Good Practices”, which has been used to assess corruption risks in the health sector and design and implement a corruption risk mitigation plan.
  2. UNDP closely works with UNODC to provide anti-corruption support to partners and member states. While UNODC focuses on the review and the implementation of the United Nations Convention Against Corruption (UNCAC), UNDP focuses on governance and anti-corruption to strengthen transparency, accountability and integrity mechanisms to prevent corruption.
  3. UNDP Global Anti-corruption Initiatives (GAIN) brings together UNDP global knowledge and expertise on anti-corruption. UNDP also works very closely with WHO, World Bank and other partners to apply an integrated and multi-disciplinary approach on anti-corruption through improved partnerships and coordination both within and outside UN system.

Additional guidance, tools on strengthening systems for Health can be found here;