Effect of corruption on perceived difficulties in healthcare access in sub-Saharan Africa

dc.contributor.authorHsiao, Amber
dc.contributor.authorVogt, Verena
dc.contributor.authorQuentin, Wilm
dc.date.accessioned2019-11-07T18:04:00Z
dc.date.available2019-11-07T18:04:00Z
dc.date.issued2019-08-21
dc.description.abstractBackground 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.en
dc.description.sponsorshipDFG, 414044773, Open Access Publizieren 2019 - 2020 / Technische Universität Berlinen
dc.identifier.eissn1932-6203
dc.identifier.urihttps://depositonce.tu-berlin.de/handle/11303/10276
dc.identifier.urihttp://dx.doi.org/10.14279/depositonce-9238
dc.language.isoenen
dc.relation.ispartof10.14279/depositonce-17151
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/en
dc.subject.ddc610 Medizin und Gesundheitde
dc.subject.othersub-Saharan Africanen
dc.subject.otherhealthcare accessen
dc.titleEffect of corruption on perceived difficulties in healthcare access in sub-Saharan Africaen
dc.typeArticleen
dc.type.versionpublishedVersionen
dcterms.bibliographicCitation.articlenumbere0220583en
dcterms.bibliographicCitation.doi10.1371/journal.pone.0220583en
dcterms.bibliographicCitation.issue8en
dcterms.bibliographicCitation.journaltitlePLOS ONEen
dcterms.bibliographicCitation.originalpublishernamePLOSen
dcterms.bibliographicCitation.originalpublisherplaceSan Francisco, California, USen
dcterms.bibliographicCitation.volume14en
tub.accessrights.dnbfreeen
tub.affiliationFak. 7 Wirtschaft und Management::Inst. Technologie und Management (ITM)::FG Management im Gesundheitswesende
tub.affiliation.facultyFak. 7 Wirtschaft und Managementde
tub.affiliation.groupFG Management im Gesundheitswesende
tub.affiliation.instituteInst. Technologie und Management (ITM)de
tub.publisher.universityorinstitutionTechnische Universität Berlinen

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