MUTARE– At least eight in ten Zimbabweans lack confidence in the country’s health service delivery and perceive it as corrupt, preliminary findings of a report on corruption in the sector show.
In its preliminary findings from a risk assessment Transparency International Zimbabwe, gives hint of the levels of corruption within the health services sector, where at least a third of Zimbabweans say they have paid bribes to access services.
TIZ said from the findings it has become abundantly clear that corruption has permeated critical social service delivery sectors and has turned the health sector into a death trap.
In their assessment TIZ used the World Health Organization (WHO) six building blocks, a trend traceable in other global south environs, as indicators to the impact of corruption on the health sector.
The WHO describes health systems in terms of six core components or building blocks from leadership or governance, health information systems, financing, healthcare workforce, access to essential medical services and service delivery.
The report which will be launched soon, also revealed that there is an emergent phenomenon of petty corruption in the health sector where public health workers delay services to extort extra fees from clients and patients.
It also emerged that public health workers are conniving with those in the private sector to make referrals which are not genuine and share profits using public health care facilities to recruit clients and refer them to private health facilities.
“The findings (of the research) will assist us in providing policy recommendations to government and better position civic society, citizens to hold duty bearers to account.
“We do not want dwell on anecdotal narratives of corruption but we are focused on conducting research to provide empirical evidence,” said Tafadzwa Chikumbu, TIZ team leader.
The research methodology focused on extracting opinions and perceptions from respondents, consultants said general findings paint a gloomy picture and a growing trend where even health workers are exhibiting rentseekign behavior.
Prosper Maguchu a lead consultant, said the research only scratches the surface as emergent issues not primarily focused in their assessment also reveal the deep seated nature of graft within the body politic of Zimbabwe.
He said the health budget allocation falls short of the agreed 15 per cent of budget, a minimum in accordance to the 2001 African Unions’ Abuja declaration, despite 70 per cent financing for Zimbabwe’s health sector being provided by international partners.
“Corruption in Zimbabwe has turned the health sector into death trap, corruption is not a victimless crime there are victims behind this.
“We are trying to put faces on the impact of corruption in the health sectors. People may have to resort to other alternatives to get health services, like traditional healers.
“While corruption is matter of perception and cannot be measured imperially as it is secretive, we rely on the public perceptions and in terms of perceptions 85 percent of our respondents have no confidence in the heath sector,” said Maguchu.
“Poor financing makes the sector vulnerable as underpaid works connive referrals, extort patients to make extra money which can be described as survival corruption but the conflict of interest makes it unethical and as costly as grand corruption.
“Financing is a very important aspect as the health sector needs adequate financing but in our case the trend is that there has been a gradual decline of budget allocations to the sector. On average budget allocations are 6 to 9 percent which is almost 50 percent lower than the Abuja Declaration agreement,” said Maguchu.
WHO blocks state that healthcare workers need proper remuneration as motivated staff provide better service delivery, inversely without incentives poverty drives of corruption leading to absenteeism, embezzlement, over charging and favoritism.
In terms of access to essential medical services- in the study it was discovered that distribution of pharmaceutical products by National Pharmacy is not transparent and this secrecy in distribution is creating a rent seeking opportunity for unscrupulous politicians, individuals and workers.
Public institutions are made to pay oversized goods by well-connected individuals 74% of respondents were asked to pay bribes to access health care services 23 percent preferred not to say, these are significant figures.
“Most patients are vulnerable because of information symmetries, majority do not have proper information to make right decisions to fight corruption or even resist paying unnecessary bribes.
“Bribes paid by clients and patients, can be classified as petty but has an impact in enjoyment of health rights. If it becomes systemic it can still have impact on the access of health services, we should also look at its impact on the health service delivery.
“The health sector is not properly financed and this in itself makes the sector vulnerable, underpaid works connive for referrals and rely on extortions to make extra money this can be classified as survival corruption.
“Bribes are also paid in non-monetary form that’s a misperception that has been made by people that this is not corruption when it has an impact on the enjoyment of socio economic rights. We need to devise ways to find more information because this is a grey area,” said Maguchu.
