Health Sector

Vulnerabilities to corruption in the health sector: Perspectives from Latin-American sub-systems for the poor (with a special focus on the sub-national level)

National health systems in Latin America and the Caribbean are very heterogeneous and it is likely that risks to corruption differ depending on how funds are mobilized, managed and paid. At the same time, there are areas of the health systems that tend to face similar vulnerabilities. This study produced by the UNDP Regional Centre Panama explores corruption vulnerabilities of the Colombian and Peruvian health systems for the poor. It finds that in the  Colombian Subsidized System, with payment-provider split and competitive health insurance mechanisms, vulnerabilities are related in particular to fraud and corruption in contract management,  claims processing and beneficiary affiliation. Also decentralization, in particular in the administration of funds, seems to have implied a “decentralization of corruption risks”. The Peruvian health system for the poor, which relies on direct public provision of health services managed by the Ministry of Health, is particularly vulnerable in the area of human resources (absenteeism, “buying” jobs, etc) as well as the management of drugs, supplies and capital assets. On the other hand, the procurement of drugs and medical equipment continues to be an area of concern in Colombia and Peru alike, despite important reform efforts in both countries.