African patients who had to pay a bribe for healthcare report difficulty in accessing care.
A large survey in sub-Saharan Africa found that adults who had to pay bribes for healthcare in the past year were between four and nine times as likely to have difficulty in accessing medical services. The data comes from a survey carried out from 2014-2015 in 32 countries.
Tit for tat
“When patients in sub-Saharan Africa have to pay bribes for healthcare, they are much more likely to report difficulties in obtaining medical care,” says lead author Amber Hsiao from the Technical University of Berlin.
“Bribery at the point of care and its implications need to be better monitored and addressed in the quest to reach universal health coverage.”
Having to pay a bribe can discourage people from seeking care when they need it, and erodes public confidence in the healthcare system. However, the extent to which the practice limits healthcare access has been unclear. The study aimed to find out.
Out of 31,322 adults who had received medical care between 2014 and 2015, roughly 14% said they had to bribe to obtain care at least once in the past year. After controlling for regional and individual factors, the team found that survey respondents who had paid one or two bribes were 4.11 times more likely to encounter difficulty in obtaining care. Those who reported paying bribes “often” were nine times more likely to have the same issue.
Controlling for individual and regional factors, survey respondents who had paid one or two bribes were 4.11 times more likely to report difficulties in obtaining care than those who had paid no bribes.
The team hopes that their findings can help guide the efforts of policymakers and researchers as they work toward the United Nations’ goal of universal health coverage by 2030. They also recommend further research on individual countries to find strategies of combating bribery and healthcare corruption in general.
The paper “Effect of corruption on perceived difficulties in healthcare access in sub-Saharan Africa” has been published in the journal PLoS ONE.
