Research and Consulting Projects on the Topic of Anti-Corruption and Health

Dr. Vian and collaborators William Savedoff and Harald Mathisen are co-editors of a new book, Anticorruption in the Health Sector: Strategies for Transparency and Accountability. Its 13 chapters present information on the causes and consequences of specific types of corruption affecting health programs, and present real-world experience of health policy makers and program managers who have tried to implement anticorruption strategies. This book fills a gap in the literature, hinting that reform is within reach if we can change incentives and build local capacities.

New Briefs

Benefits and Drawbacks of Per Diems: Do Allowances Distort Good Governance in the Health Sector? by Taryn Vian.

Approaches to Teaching and Learning about Corruption in the Health Sector? by Taryn Vian.

Boston University's ACT for Health program is proud to announce that it is part of a winning consortium which was awarded in March: the Encouraging Global Anticorruption and Good Governance Efforts (ENGAGE) Indefinite Quantity Contract (IQC) by the U.S. Agency for International Development (USAID). The prime contractor for this award is Casals & Associates http://www.casals.com/ with headquarters in Alexandria, Virginia.

The five-year, multi-award contract has a potential value of $750 million. Through ENGAGE, the partners will provide a wide range of anticorruption and good governance technical services to host country governments, civil society organizations, and the private sector. Boston University School of Public Health will provide targeted assistance on health sector governance, transparency, and accountability issues.

Other partners on the ENGAGE project include The Asia Foundation, AMIDEAST, Claro & Associates, Inc., Commonwealth Trading Partners, Inc., EAM, Inc./Mosley & Associates, EDF Consulting Inc., The Emergence Group, Enterprise Solutions, Inc., The Eurasia Foundation, Mendez England & Associates, Inc., Pact International, Vanderbilt University, and World Resources Institute.

Taryn Vian recently published a Review Paper on Corruption in the Health Sector in the journal Health Policy and Planning (click the above link or download the PDF). The article is available for free without subscription, through the generous funding of the U4 Anticorruption Resource Centre in Norway.

BU hosted meeting of the WHO Collaborating Center for Drug Policy reviews initiatives on transparency and governance, including a DFID-funded Medicines Transparency Alliance study of drug prices led by BU professor Brenda Waning.

Dr. Vian recently helped update the health-related theme pages of the web site of the U4 Anti-Corruption Resource Centre, a web-based knowledge bank established by the Utstein Development Agencies to strengthen their efforts against corruption. Development agencies from Canada , Germany , the Netherlands , Norway , Sweden , United Kingdom are partners committed to concerted action to reduce the damaging effects of corruption. The U4 Resource Centre is operated by the Chr. Michelsen Institute (CMI), Bergen , Norway , a private social science research foundation working on issues of development and human rights. The Transparency International Secretariat in Berlin also supports the Centre.

ACTforHealth is currently working with the U4 Anticorruption Resource Center to produce a series of Anticorruption Briefs.  Please send your ideas for other briefs to Taryn Vian (tvian@bu.edu). The following briefs are completed: 

           Reducing Vulnerabilities to Corruption in User Fee Systems
This brief illustrates how one hospital introduced policy and system changes to reduce corruption and increase responsible stewardship of user fee revenues
           Using Financial Performance Indicators to Promote Transparency and Accountability in Health Systems
          (with co-author David Collins, MSH)
Looks at district health planning and reporting in South Africa, and how integration of financial data and utilization statistics helped increase transparency
           Preventing Drug Diversion through Supply Chain Management
A case study which describes how the Supply Chain Management System Project is working to increase transparency in HIV/AIDS drug supply.

Other Briefs

           Embezzlement of Donor Funding in Health Projects, by Katherine Semrau, Nancy Scott, and Taryn Vian

           Transparency and Accountability in an Electronic Era: the Case of Pharmaceutical Procurement, by Brenda Waning and Taryn Vian

           The Impact of Information and Accountability on Hospital Procurement Corruption in Argentina and Bolivia, by William Savedoff

           Pay for Honesty? Lessons on Wages and Corruption from Public Hospitals, by William Savedoff

           Transparency in Health Programs, by Taryn Vian

           Fraud in Hospitals, by Steve Musau and Taryn Vian

Transparency International’s Global Corruption Report 2006 was released on February 1, 2006 . Taryn contributed a chapter on Corruption in Hospitals. Other chapters cover topics such as informal payment, procurement corruption and conterfeit drugs, and health system vulnerabilities to corruption.

In October 2005, Professor Vian participated in an anticorruption assessment study in Azerbaijan , for the USAID/Caucasus Mission. Her paper on Vulnerabilities in the Health Sector examines issues of informal payments and pharmaceutical corruption, as well as kickbacks to retain government positions and issues of governance in the Global Fund program.

In 2004, Professor Vian won a competitive University faculty grant to study the practice of informal payments using a social behavior decision-making model called the "theory of planned behavior" (TPB). The study included 222 respondents from different areas of Tirana, the capital city. The first paper, “Examining and Predicting Under-the-Table Payments for Healthcare in Albania: An application of the Theory of Planned Behavior” was published in the Journal of Applied Social Psychology.  The second paper, “Beliefs about Informal Payments in Albania” has come out in Health Policy and Planning. The findings can help health care managers to design behavior change strategies that can complement structural reforms meant to reduce informal payments.

Recent papers by researchers from BU’s Center for International Health and Development focus on corporate social responsibility, a field that is related to some of the ethical dimensions of corruption and health.  The evaluation results of a Pfizer program were published in Human Resources for Health and Human Resources Planning Journal.

Emory University MPH graduate Ethan Joselow wrote his thesis on informal payments for health services in Karnataka, India.  Click here to read a copy.  Ethan's thesis approaches the problem from a variety of angles, from more criminological approaches to looking at how corporate structure and political culture play a role in supporting corrupt behavior.  His thesis was designed as a policy paper for the Government of Karnataka's Ministry of Justice.