Corruption in the African Healthcare System: Where is the Aid Money Really Going?

The matter of healthcare is an important issue that plagues both developing, as well as developed countries.  The causes of healthcare problems are different depending upon the region.  In most African countries, lack of funding has caused the healthcare system to be ineffective.  However, if millions of dollars of aid are given to countries each year for healthcare development alone, how are these issues still present? 

            Corruption is a serious problem in most governmental institutions for many African countries, especially in the healthcare department.  The World Bank created the term “quiet corruption” in 2010 to explain why healthcare systems are failing and said it was a major reason why African countries cannot succeed in fully developing. [1]  Hospitals are not receiving the funding they should be, medical deliveries are not being made, and healthcare workers are not being paid.  These are some of the real reasons why healthcare in Africa is at such a low quality.  It is a misconception that many people do not go to the doctor when they are sick or do not have access to a hospital.  Although this may be the problem in some cases, in others, people know that they will not be able to receive the healthcare they deserve because of the presence of corruption in the facilities.  “People stop looking for health because they know they won’t get it.” [1]  Africans know that once they get to the hospital or clinic, they will have to pay out of pocket for the services rendered, when in reality there was aid money given to the country for this specific cause.  Thousands of deaths could be prevented if these people were able to access the type of healthcare donors intend on providing. 

            The lack of accountability and absence of controls on medical substances can be named as the root of the corruption.  Once foreign aid money goes through the health ministries, there is little or no system of keeping track of where the money goes after or how it is used.  Facilities end up not having money to pay its healthcare workers, causing them to seek jobs elsewhere, leaving the population with a shortage of doctors and nurses.  [2]

            Fortunately, there can be a quick fix to this problem.  Unfortunately, for the governments of Africa, money would need to be given to the private sector instead of the public.  If aid was allotted more to the private sector, the money can be directly distributed to the healthcare facility, instead of going through bureaucrats.  The private sector would also need to take accountability more seriously because the donors could just as easily give the money to another non-governmental aid organization.


[1] “‘Quiet Corruption’ Impedes African Development, World Bank Report Says.” THE MEDICAL NEWS | from News-Medical.Net – Latest Medical News and Research from Around the World. 17 Mar. 2010. Web. 14 Dec. 2011. <http://www.news-medical.net/news/20100317/Quiet-corruption-impedes-African-development-World-Bank-report-says.aspx&gt;.

[2] Ayodele, Thompson. “Africa’s Failing Approach to Health Care.” National Center for Public Policy Research – A Conservative Organization. Web. 14 Dec. 2011. <http://www.nationalcenter.org/P21NVAyodeleHealth90308.html&gt;.

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One response to “Corruption in the African Healthcare System: Where is the Aid Money Really Going?

  1. Anastasia Thatcher, Global Health Lead - Accenture Development Partnerships

    I appreciate your perspective, and while corruption within the public system certainly plays a large role in the failings of many public goods (including healthcare) I must vehemently disagree that diverting funding to the private sector is somehow an “easy fix.”

    Firstly, you assume that the private sector in developing countries is not corrupt. This is often inaccurate. I agree that market incentives could motivate investment in better quality service and outcomes as a way to potentially improve customer ‘experience’ and hence future revenue streams. However, in markets where private sector health companies are nascent, and patterns of corruption are deeply embedded within society, politics, and business (I’m thinking of Kenya and Haiti, countries where I have the most personal experience) – to think that health aid dollars going into the hands of businesses will be invested in the longterm infrastructure needed in capacity-building (ie, qualified health workers), diagnostic and ancillary capabilities, IT and so forth is naive. Further, healthcare’s “customers” in developing countries are often too poor to pay into a sustainable retail system – and thus – the payers of a privatized health system will need to be established through some kind of public mechanism (or at least having public accountability and oversight) and thus — we face the challenge of public sector corruption again.

    Secondly, I think that long-term development solutions need to be embedded within the public sector. Although its very tempting to deliver programs and health interventions without engaging Ministries of Health in name of short-term impact, this will not create the access to knowledge and capacity building critically necessary to strengthen the public system, which holds the responsibility to ultimately deliver against the needs of citizens. Many have written about the failure of development organizations in Haiti to sufficiently partner with and strength local public sector actors, leading to dependency, a weaker public sector, and ultimately an undermining of the long-term development impact potential. I hope we learn from this mistakes and seek stronger models of learning and partnership to truly help create leadership and accountability within weak states.

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