A Study on "Corruption in the Health Sector in the Third World Countries": Context Bangladesh

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Partha Pradip Sarkar
ID # 3-07-11-017
MBA Evening Program
Department of Management Studies
University of Dhaka

March 2008
Executive Summary


he main objective of this study was to identify the sources and patterns of corruption in the Health Sector in Bangladesh and to analyze the causes and impacts of these corruptions. This paper describes important areas of vulnerability to corruption within the health sector and identifies approaches for prevention. Corruption in the health sector is a critical problem in developing and transitional economies where government resources are already scarce.

The major sources / areas that are identified subject to enormous unbridle corruption are like: Health care professionals, Distribution and use of drugs and supplies in public hospitals, Construction and rehabilitation of health facilities, Hospital Procurement, Regulation of quality in products and services, Education of health professionals, Health ministry and management personnel etc.

The causes of corruption in the health sector in Bangladesh can be listed as - Lack of good governance in every level of mgt. system from Upazilla health complex to the health ministry,, Acute shortage of health care facility, Illiteracy of majority beneficiaries which has opened up many opportunities for corrupt transactions, Lack of transparency and accountability in every sphere, Political alignment of trade unions, Less job satisfaction of health professionals etc.

Recommendations that are prescribed for reducing the degrees of corruption in this sector are as follows:

❑ Preventing corruption in the health sector should be linked with overall anti-corruption strategies at the national level.

❑ Good governance to be established in all spheres of the health sector in Bangladesh. Variety of barriers will be there, but the practice should be started.

❑ Declare health sector as an essential and emergency service, and enact a law banning all trade unions in hospitals for five years. Also enact a law, banning politics in medical colleges to ensure quality professionals.

❑ Downsize government, provide employment on contract basis with the flexibility of hiring and firing (though tough but not impossible), develop performance-based management systems, encourage private alternatives.

❑ Revise the drug regulation and restrict unethical drug promotion by enacting law. Introduce enforceable codes of ethics in marketing drugs through trade and professional associations.

❑ Audit committee may be formed to bring transparency in all sorts of hospital procurement and other auditable matters.

❑ Drug distribution system in the hospitals should be modernized (like digital display of inventory of medicines).Improved drug management logistics information systems and indicator-based assessments may increases accountability.

❑ Mal praxis, fraud practice (Practice by incompetent or fake professionals) and dichotomy must be stopped by continuous monitoring by law enforcing agencies.

❑ Frequent inspection by high power teams and public disclosure of inspection findings. That will increase transparency.

❑ Committee should be formed to asses risk areas of corruption in the health sector and more research should be done to develop tools and methods to assess corruption in the health sector.

1. Introduction

orruption is a concern in all countries, but it is an especially critical problem in developing and transitional economies where public resources are already scarce and inadequate management or corrupt systems can cripple growth and development. The purpose of this paper is to describe areas of vulnerability to corruption within the health sector in Bangladesh and to identify tools and approaches for reducing those corruptions.

Development economists...
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