The 130th Annual Meeting of APHA

Abstract #41432

Taryn Vian, MSc, Assistant Professor, Department of International Health, School of Public Health, Boston University, T4W, 715 Albany St, Boston, MA 02118, 617-414-1447, tvian@bu.edu

Corruption and lack of accountability in government are concerns in all countries, but they are especially critical problems in developing and transition countries where public resources are already scarce and corruption can cripple growth and development. The focus on preventing corruption and promoting accountability has been heightened in recent years by the worldwide movement toward decentralization as a health reform strategy. Decentralization provides more opportunities for corruption while at the same time empowering district and provincial health professionals to design innovative systems for preventing corruption and increasing accountability. In international health work, most public health practitioners will encounter corruption at some point and will need to make ethical and management decisions about how to work within corrupt systems and how to prevent corruption from occurring. Cultural differences in defining morality and corruption make it difficult to distinguish “acceptable” or “unacceptable” activities like trading favors, giving gifts, and using contacts. This paper reviews research and published literature on corruption in health programs in low-income and transition countries, summarizing some of the practical tools and approaches that are being used in different settings to build corruption-resistant, accountable and transparent health systems. Two specific areas of focus are improving pharmaceutical procurement systems and developing financial management and control systems under decentralization, including systems for cost recovery.

Learning Objectives:

• Discuss cultural differences in defining corruption, including problems of distinguishing corruption from activities like trading favors, giving gifts, and using contacts.
• Describe the costs of corruption in the public health sector, and discuss why corruption’s effects are more damaging to developing countries.
• Outline specific actions to improve pharmaceuticals procurement systems to prevent and detect corruption.
• Detail specific actions to improve financial management systems to prevent and detect corruption, especially within decentralized health systems and cost recovery programs.

Keywords: Accountability, Management

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.