U4 Helpdesk
Query
Corruption in the health and education sector in Mali
Have there been any reports about corruption
in health and/or education sectors in Mali?
Purpose
This information is needed for
a common in-depth assessment of sectoral budget support to
health and education in Mali.
|
Content
- Part I contains some brief background
information on corruption in Mali and the state of the education
and health sectors.
- Part II offers synopses of analyses
relating to corruption and the education and health sectors in Mali.
- Part III lists other relevant resources
on corruption in the education and health sectors more generally.
We have not found reports dealing specifically with corruption in the
education and/or health sectors in Mali. We have, however, located relevant
information from amongst a wide range of reports dealing with governance,
corruption and development assistance in Mali. We have searched sources
from the World Bank (WB) including the Mali Poverty Reduction Strategy
Plan (PRSP), Public Expenditure Tracking Surveys (PETS) and programme
assistance documents on Mali. We have also searched sources from the
UN as well as various Ministries of International Development. Relevant
information from these reports on corruption in the education and heath
sectors in Mali, has been extracted and synthesised. The U4 Helpdesk
has also requested documents from contacts within Mali. We have not
received any documents thus far but will forward any documents we might
receive. Since we have drafted this response in half the time normally
required for our research we caution that there may be further information
that we have not yet located. We have not included more general information
on direct budget support and public financial management since this
was not explicitly requested, although we indicate where such information
may be found.
Please also see:
[top]
U4 helpdesk reply
Part I: Background to Corruption in Mali and the state of Education
and Health Sectors
The UN offers an assessment
of corruption in Mali and an assessment of the state of the education
and health sectors. A summary is offered here.
(1) Corruption in Mali
In March 1999 the World Bank investigated corruption in Mali and
set out a list of reforms that needed to be taken. This was followed
up in 2001 with an evaluation of reforms actually undertaken to counter
corruption. In April 2002 the WB published an Anti-Corruption Report
with recommendations focusing on three issues:
a) limiting opportunities for corruption
b) applying necessary sanctions
c) achieving greater transparency in government operations.
On August 7, 2002, President Amadou Toumani Touré created
an ad hoc committee of thirty members to study the Anti-Corruption
Report's recommendations. Faced with the increasing scale of corruption,
the Government decided, during its June 25th 2002 meeting, to implement
vigorous measures, rules and procedures with respect to
i) public contracts and purchasing;
ii) introducing transparency in the operation of services,
iii) implementing the provisions of the new penal code and those of
the penal procedure
iv) setting up of economic and financial pools.
The summary on the UN website states: "The fact remains that
the weakness of systems of accountability and sanctions remain a major
challenge in the fight against corruption."
(2) Education and crisis of the school system
For several years, Mali's education system has been experiencing
a crisis that some protagonists of the education system explain by
the fact that the actors are highly politicized. The deterioration
is also explained by reference to population growth.
The government adopted a ten year education program (PRODEC),
a very comprehensive program which received the support of all donors.
The PRODEC is made up of three components: i) improving the quality
of teaching and learning methods by focusing the educational system
on the basic educational needs of learners and on the quality of education;
ii) improving access to school enrollment in order to increase the
rate of coverage; iii) strengthening the capacities of the school
system for decentralization and monitoring policies in order
to modernize the management of the education sector. (Source:
Report on partnership Mali, World Bank, 2001)
(3) Health
The Government adopted in 1998 a ten year health and social development
plan (PDSS) covering the period 1998-2007. This plan aims to ensure
financial and geographical accessibility, for the entire population,
to quality health services. It also aims to reduce mortality linked
to priority diseases, to enhance the performance of health services
and to guarantee fair and sustainable funding of the health system
and social action.
The ten year health and social development plan (PDDSS) included
an initial five year program of health and social development (PRODESS)
1998-2002. The PRODESS aimed at (i) widening access to health care
and reference services; (ii) improving the quality, efficiency and
effectiveness of socio- health services including those related to
reproductive and nutritional health and (iii) strengthening the
state's institutional capacities at organizing, managing, monitoring
and evaluating the health and social system.
STDs/AIDS constitute a national concern. The National Program
for the fight against AIDS (PNLS) was created in 1987. The "Strategic
fight against AIDS" plan covered the period 2001-2005. Implementation
of the plan was coordinated by a Coordination Bureau attached to the
Cabinet of the Ministry of Health. This program aimed specifically
at: (i) preventing transmission in the overall population, with a
special emphasis on the most vulnerable population groups and mother
to child transmission; (ii) improving the quality of life of people
living with HIV and alleviating the burden of the impact on affected
families and the community; (iii) reducing the impact on health services
and (iv) establishing an ethical and legal environment conducive to
the respect for human rights.
[top]
Part II: Corruption in Education and/or Health sectors in Mali
(1)
Mali Poverty Reduction Strategy Paper (PRSP)
A starting place to begin the search for information on corruption
risks in the education and health sectors is in Mali's PRSP. PRSPs
describe a country's macroeconomic, structural and social policies
and programs, to promote growth and reduce poverty, as well as associated
external financing needs. PRSPs are prepared by governments through
a participatory process that involves civil society and development
partners, including the World Bank and the International Monetary
Fund (IMF). The latest PRSP prepared for Mali was in 2002.
Part 3, sections 12 and 13 of the Mali PRSP set out the state of
Mali's health and education sectors, respectively.
In Section 12 "Strengthening Health, Nutrition and Population
Services" new approaches to healthcare provision are set
out. These approaches are relevant for understanding effective ways
of allocating resources - and may indicate ways to avoid corruption,
mismanagement or inefficiency in the health sector. Amongst approaches
recommended to strengthen health care provision are an NGO initiative:
the professionalization of the National Center of Information, Education
and Communication on Health Issues (CNIECS); the promotion of the
contract-based approach (performance contracts with the local communities,
communes, the NGOs and state structures); support for innovative initiatives
for alternative financing, solidarity and social protection; and the
setting up of mechanisms ensuring the effective participation of target
groups (women, young people, the handicapped) in health promotion.
The Mali PRSP indicates that one of the risk factors in the spread
of HIV/Aids is the weakness of the ethical and legal framework. It
goes on to say that the government is committed to strengthening this
framework.
Section 13 "Strengthening Education and Literacy Programs"
mentions the main program through which reforms in the Mali Education
sector will be made: the education sector investment project (Programme
d'investissement du secteur éducation - PISE). The following
section (2) of this response describes this programme.
(2)
World Bank Programme Assistance Document
The World Bank is implementing a "Mali Education Sector Expenditure
Program II (PISE)", building on the first phase of the WB Education
Sector Expenditure Program (ESEP). In its Project Information Document
the WB notes that "Quality is a major concern; completion rate
in primary education remains very low at 40%, which is a major constraint
for Mali durable development, and repetition rate is not improving…"
It attributes major causes of these concerns to, amongst others, "inefficient
provision of textbooks … [and] ineffective quality/performance
monitoring".
The Programme Assistance Document notes that in Mali the legal framework
for decentralization of the provision and management of education
services is in place. However municipalities have only limited technical
capacity to manage education services; there is no sustainable
action plan and budget in place for each region; resources have
not been transferred to the municipalities; CAPs are not yet fully
involved in monitoring quality and, finally, monitoring, reporting,
financial management and auditing are still ineffective.
Lessons learned from the first phase of the ESEP that may be of significance
for anti-corruption efforts include that the project should incorporate
an instrument to support parental involvement in basic education and
to make the administration more accountable. Furthermore, during
the program preparation stage a tool for planning education budget
programming at the national and regional levels should be agreed upon.
Another lesson learned was that a supervision / monitoring tool should
be agreed upon between Government and donors participating in budget
support.
The second phase of the ESEP is projected to take place over three
years. In line with the Government of Mali's request that donors should
harmonize their procedures regarding support of the education sector,
the WB has proposed four components of its support. These are:
(a) Improvement of access and completion in basic education through,
amongst other efforts, the improvement of school management by strengthening
the leadership of school directors, parents' involvement and performance
monitoring.
(b) Development of secondary, technical and vocational education.
(c) Design and Implementation of a sustainable development policy
for higher education and scientific research
(d) (of particular significance for anti-corruption efforts) Strengthening
governance of the education sector at central and local levels
by developing standards at decentralized levels and developing performance
monitoring; strengthening decentralization with regional budget allocation
and transfer of resources to local governments; strengthening technical
support provided to local government by central government and strengthening
school management at primary and secondary education levels with increased
parents' involvement.
The Programme Assistance Document also notes that budget support
to education would be carried out according to the following
principles:
(i) The budget framework would prioritise basic education.
(ii) Annual disbursement would be conditioned by the provision of
financial and physical audit.
(iii) Financing would be provided based on an agreed annual action
plan at central and regional levels.
(iv) Financing would be divided into an unconditional (fixed) portion
and a variable portion.
(3)
Operations Evaluation Study: Development Effectiveness in Health,
Nutrition and Population: Lessons from World Bank Experience, Volume
1
Within this Operation and Evaluation Department (OED) study, you will
find an executive summary (pages 49 to 53) of WB development assistance
to the Health sector in Mali. This report is from 1999, but it assesses
twenty years of WB health projects in Mali. The Lessons Learned
(that may be of relevance to anti-corruption concerns) include:
(a) During fiscal adjustment, the Bank and government must pay attention
both to protecting overall allocations to the social sectors and to
the efficiency of expenditures within the social sectors.
(b) While rural cost recovery can be important to sustain local services,
the funds raised typically are small relative to overall government
health spending, which often remains focused on urban curative care.
(c) Shifting a previously centralized health delivery system to one
based on district-level planning and community participation requires
changing incentives together with intensive technical support
both for districts and communities.
(d) The Bank should give greater emphasis to rigorous monitoring
and evaluation, and operations research, particularly when piloting
new service delivery mechanisms that are then scaled-up nationwide.
(4) Public Expenditure Tracking Survey (PETS)
The aim of PETS is to answer the question: "Does public money
spent on health and education actually reach frontline health facilities
and schools?" They seek to achieve this by tracking the flow
of public resources through various layers of the administrative hierarchy
to individual service providers, and by developing quantitative estimates
of fiscal leakage - that is, the failure of resources intended for
frontline service provider (clinics and hospitals) facilities to reach
their intended destination."
(M. Lindelow, I. Kushnarova and K. Kaiser, Measuring corruption in
the health sector: what we can learn from public expenditure tracking
and service delivery surveys in developing countries, GCR
2006 "Corruption and Health".
The U4 website includes extensive information
on PETS.
The World Bank is preparing a PETS in the education sector in
Mali. We have also learnt that other PETS in the education and
health sectors are being prepared. At this stage we do not have further
information, but once this becomes available we will be happy to forward
it.
Note: In the GCR article referred to above it is shown that
"while many PETS have generated valuable insights, practical
and methodological challenges have often made it difficult to develop
firm and comprehensive estimates of leakage." The article emphasises
that PETS should not replace other parts of the public financial management
system. The information on the U4 website link, above, describes the
use and limits of PETS in assessing corruption.
[top]
Part III: Other resources
(1) Global Corruption Report 2006 on "Corruption
and Health"
The GCR 2006 sets out a wealth of information on corruption and the
health sector. Whilst not including information on Mali per se, it
does make general recommendations for the health sector. These may
be found in the Executive
Summary section.
In summary the TI recommendations include recommendations on transparency,
the introduction of codes of conduct, the participation of civil society
and oversight, whistleblower protection, ways to reduce incentives
for corruption, conflict of interest rules, the use of integrity pacts
and debarment as well as recommendations on rigorous prosecution.
(2) Annotated literature from the U4 website pages
on corruption in the health and education sectors
The U4 webpages on corruption in health
and education include extensive lists of articles that may be relevant
for your particular needs. Please see the literature
review on corruption and education, and the annotated
links from the new health pages (2006) for more details.
We hope you find this information useful. If you are compiling a
report on corruption in the health and education sectors in Mali we
would be delighted to receive a copy so that we can make it available
to other U4 partner agencies.
[top]
| 
