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Main Title: Effect of corruption on perceived difficulties in healthcare access in sub-Saharan Africa
Author(s): Hsiao, Amber
Vogt, Verena
Quentin, Wilm
Type: Article
Language Code: en
Abstract: Background Achieving Universal Health Coverage (UHC) by improving financial protection and effective service coverage is target 3.8 of the Sustainable Development Goals. Little is known, however, about the extent to which paying bribes within healthcare acts as a financial barrier to access and, thus, UHC. Methods Using survey data in adults from 32 sub-Saharan African countries in 2014–2015, we constructed a multilevel model to evaluate the relationship between paying bribes and reported difficulties of obtaining medical care. We controlled for individual-, region-, and country-level variables. Results Having paid bribes for medical care significantly increased the odds of reporting difficulties in obtaining care by 4.11 (CI: 3.70–4.57) compared to those who never paid bribes, and more than doubled for those who paid bribes often (OR = 9.52; 95% CI: 7.77–11.67). Respondents with higher levels of education and more lived poverty also had increased odds. Those who lived in rural areas or within walking distance to a health clinic had reduced odds of reporting difficulties. Sex, age, living in a capital region, healthcare expenditures per capita, and country Corruption Perception Index were not significant predictors. Conclusions We found that bribery in healthcare is a significant barrier to healthcare access, negatively affecting the potential of African countries to make progress toward UHC. Future increases in health expenditures—which are needed in many countries to achieve UHC—should be accompanied by greater efforts to fight corruption in order to avoid wasting money. Measuring and tracking health sector-specific corruption is critical for progress toward UHC.
Issue Date: 21-Aug-2019
Date Available: 7-Nov-2019
DDC Class: 610 Medizin und Gesundheit
Subject(s): sub-Saharan African
healthcare access
Sponsor/Funder: DFG, 414044773, Open Access Publizieren 2019 - 2020 / Technische Universität Berlin
Journal Title: PLOS ONE
Publisher: PLOS
Publisher Place: San Francisco, California, US
Volume: 14
Issue: 8
Article Number: e0220583
Publisher DOI: 10.1371/journal.pone.0220583
EISSN: 1932-6203
Appears in Collections:FG Management im Gesundheitswesen » Publications

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