STAKEHOLDERS across sectors, including academics, health, media and civil societies are divided over the report by the United Nations Office on Drugs and Crime (UNODC), which revealed that 45 per cent of health service users in Nigeria were asked to pay bribes before accessing healthcare.
This formed part of the discourse on Monday, July 29, when Health Sector Anti-Corruption Project Advisory Committee (HAPAC), hosted a webinar on the topic, “Reflection from the 2024 corruption in Nigeria survey as it Impacts the health sector”.
The discussion centred on the findings of the UNODC’s third edition of corruption in Nigeria, trends and patterns, focusing on bribery and its extensive implications on the health sector.
Speaking at the webinar, the Chairman of HAPAC, Idris Muhammed, noted that while the report revealed bribery being rampant and deeply entrenched in the sector, some health workers have called for a more critical look at the report.
“Since the report made it to the public domain, health workers from several quarters have continued to react, citing insensitivities and flawed methodology. Some health workers have also called for a more critical look at the report and suggested steps to improve anti-corruption within the health sector,” Muhammad said.
Synopsis into the UNODC report
The survey, which was conducted in partnership with the National Bureau of Statistics (NBS) and the MacArthur Foundation, revealed that nearly half of those seeking medical services in Nigeria encountered demands for bribes, often for services that are supposed to be free or to expedite treatment processes.
The report also showed the health sector as being among the top four homes for bribery in the country.
While presenting the report, Prince Agwu, from the University of Dundee and a member of the Health Policy Research Group NSUKKA, noted a significant increase in bribes paid in the private health facilities, implicating doctors in the private hospitals.
In the report, 70 per cent of Nigerians asked to pay bribes refused.
Meanwhile, generally about 95 per cent of bribes, totaling an N721 billion were paid across sectors, according to the synopsis of the report, representing approximately 0.4 per cent of Nigeria’s GDP.
Stakeholders weigh in
During the webinar, panelists while speaking on the prevalence of bribery as reported by the UNODC, noted that there were several other issues bedeviling the health sector in the country.
The Executive Director, International Centre for Investigative Reporting, ICIR, Dayo Aiyetan, noted the divergence in perspectives between the survey data and real-world experiences as reported by journalists who worked under the organisation’s health reporting project.
Aiyetan argued that investigations in primary healthcare centres across Nigeria showed a range of systemic problems beyond bribery, including misapplication and mismanagement of resources.
He said: “We operated in 12 states before. As we speak, there are journalists on that project operating in seven focal states. And sincerely speaking, our experience, the data we gathered from the field, they are entirely different from the bribery that we’re talking about…”
Meanwhile, speaking on its findings, the UNODC National Programme Officer, Princess Chifiero, highlighted the relevance of SDG Goal 16.5, which targets the reduction of bribery and corruption.
She explained that the UNODC, in collaboration with the UNDP and other partners, developed a statistical framework to measure bribery, contextualised with guidance from National Statistics Bureau.
According to her, the framework facilitated the collection of robust data, including a substantial sample size of 33,000 respondents, one of the largest in Africa.
Chifiero emphasised that bribery is a measurable form of corruption, making it easier to gather data through direct questions.
On his part, Muktar Gadanya, a professor, explained that the comprehensive data collection, with a sample size of 30,000 respondents, allowed for detailed sub-national analysis, should any organisation or individual have a problem with the methodology.
Mukhtar argued that while the national index is essential for gauging overall progress, the data’s robustness also supported secondary analysis.
He also addressed misconceptions about gifts and corruption, noting that gifts in the healthcare sector, such as money from patients, should be declared and taxed according to personal income laws.
“The last one on issue of why bribery is a focus. The SDG’s talked specifically about bribery, which is sort of cross cutting, and when you look at bribery, it affects the demand and supply sides. So a person is asking and the person is giving,” Gandaya noted.
In its reaction, the Association of Nigerian Private Medical Practitioners voiced its concerns regarding the UNODC report on bribery being rampant in the private sector.
The president of the private medical practitioners, CN Moses, represented by Chikaike Nnamdi, said the organisation had been at the forefront of combating various vices in the health sector, including bribery and indiscipline among practitioners.
While acknowledging that corruption, including inflation of bills, did exist, he noted that in private practice, bribery was not prevalent.
“This bribery and corruption thing has always been highlighted more as if the private practitioners are very dubious, not really true. We are not,” he added.
Proffering of solutions
The stakeholders therefore highlighted the importance of more transparent data-driven research to combat corruption and proposed several actionable solutions in the health sector.
They also agreed on the necessity of involving health workers in the reform process to ensure that policies are informed by on-the-ground realities.
The stakeholders also noted that with corruption in the health sector impacting millions of Nigerians, there was urgent need for transparency, effective policy that would protect users who report bribery and other forms of corruption.
Usman Mustapha is a solution journalist with International Centre for Investigative Reporting. You can easily reach him via: [email protected]. He tweets @UsmanMustapha_M