Beyond Talking: We Need Effective Measures to Tackle Systemic Corruption and the Power That Allows It to Persist in Health Systems; A Response to Recent Commentaries.

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How Do Nigerian Newspapers Report Corruption in the Health System?

BACKGROUND: Nigeria has a huge burden of corruption, with the health system especially vulnerable. The media can play a role in tackling it, by shaping the narrative around it. However, its influence depends on the extent and framing of its reporting on corruption. This paper reviews, for the first time, coverage of corruption in the health system in the Nigerian print media. METHODS: The top 10, by circulation, newspapers in Nigeria were selected and searched using the LexisNexis database for articles covering corruption in the health sector over a 2-year period (2016-2018). Two newspapers are not included in the database and were searched manually. 135 articles were identified and subject to content and framing analyses. RESULTS: The Punch newspaper had the highest number of publications focussed on corruption in the health sector. The National Health Insurance Scheme (NHIS) was the organization attracting most coverage, followed by the Federal Ministry of Health. Corruption in the health sector was predominantly framed as a political issue. Most coverage was episodic, focused on the details of the particular case, with much less thematic, delving into underlying causes. Corruption was most often attributed to a lack of accountability while enforcement was the most frequent solution proffered. CONCLUSION: This study highlights the potential role of media analyses in helping to understand how newspapers cover corruption in the health sector in Nigeria. It argues that the media has the potential to act as an agent of change for tackling corruption within the health sector

What and how: doing good research with young people, digital intimacies, and relationships and sex education

© 2020, © 2020 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. As part of a project funded by the Wellcome Trust, we held a one-day symposium, bringing together researchers, practitioners, and policymakers, to discuss priorities for research on relationships and sex education (RSE) in a world where young people increasingly live, experience, and augment their relationships (whether sexual or not) within digital spaces. The introduction of statutory RSE in schools in England highlights the need to focus on improving understandings of young people and digital intimacies for its own sake, and to inform the development of learning resources. We call for more research that puts young people at its centre; foregrounds inclusivity; and allows a nuanced discussion of pleasures, harms, risks, and rewards, which can be used by those working with young people and those developing policy. Generating such research is likely to be facilitated by participation, collaboration, and communication with beneficiaries, between disciplines and across sectors. Taking such an approach, academic researchers, practitioners, and policymakers agree that we need a better understanding of RSE’s place in lifelong learning, which seeks to understand the needs of particular groups, is concerned with non-sexual relationships, and does not see digital intimacies as disconnected from offline everyday ‘reality’

What drives health workers to break the rules and use public resources for private gain? A review of the literature on sub-Saharan Africa

The health sector has long been identified as being one of the most corrupt in high-, middle- and low-income countries. It faces particular challenges given competing incentives of public and private providers, knowledge asymmetry between providers and patients/clients, and the vulnerability of those seeking care. Corruption takes different forms, including informal payments, absenteeism, medicine theft, fraud and bribes for professional advancement. This working paper contributes to the debate on corruption within health systems in low- and middle-income countries by reviewing theory development and empirical evidence on the ways in which social structures and political economy factors drive corrupt provider practice in sub-Saharan Africa. It explores conditions that enable corrupt activities among health workers – examining evidence on the morality or justifications for corruption – and how these relate to the health system, social structures and the political economy in particular contexts

We Need to Talk About Corruption in Health Systems.

The health sector consistently appears prominently in surveys of perceived corruption, with considerable evidence that this has serious adverse consequences for patients. Yet this issue is far from prominent in the international health policy discourse. We identify five reasons why the health policy community has been reluctant to talk about it. These are the problem of defining corruption, the fact that some corrupt practices are actually ways of making dysfunctional systems work, the serious challenges to researching corruption, concerns that a focus on corruption is a form of victim blaming that ignores larger issues, and a lack of evidence about what works to tackle it. We propose three things that can be done to address this situation. First, seek consensus on the scale and nature of corruption. Second, decide on priorities, taking account the importance of the particular problem and the feasibility of doing something about it. Third, take a holistic view, drawing on a wide range of disciplines

We Need to Talk About Corruption in Health Systems

The health sector consistently appears prominently in surveys of perceived corruption, with considerable evidence that this has serious adverse consequences for patients. Yet this issue is far from prominent in the international health policy discourse. We identify five reasons why the health policy community has been reluctant to talk about it. These are the problem of defining corruption, the fact that some corrupt practices are actually ways of making dysfunctional systems work, the serious challenges to researching corruption, concerns that a focus on corruption is a form of victim blaming that ignores larger issues, and a lack of evidence about what works to tackle it. We propose three things that can be done to address this situation. First, seek consensus on the scale and nature of corruption. Second, decide on priorities, taking account the importance of the particular problem and the feasibility of doing something about it. Third, take a holistic view, drawing on a wide range of disciplines

Targeting systems not individuals:Institutional and structural drivers of absenteeism among primary healthcare workers in Nigeria

Universal Health Coverage (UHC) can only be achieved if people receive good quality care from health workers, yet in Nigeria, as in many other low- and middle-income countries (LMICs), many health workers are absent from work. Absenteeism is a well-known phenomenon but is often considered as the self-serving behaviour of individuals, independent from the characteristics of health systems structures and processes and the broader contexts that enable it. We undertook a qualitative inquiry among 40 key informants, comprising health facility heads and workers, community leaders and state-level health policymakers in Nigeria. We employed a phenomenology approach to examine their lived experiences and grouped findings into thematic clusters. Absenteeism by health workers was found to be a response to structural problems at two levels –midstream (facility-level) and upstream (government level) – rather than being a result of moral failure of individuals. The problems at midstream level pointed to an inconsistent and unfair application of rules and regulations in facilities and ineffective management, while the upstream drivers relate mainly to political interference and suboptimal health system leadership. Reducing absenteeism requires two-pronged interventions that tackle defects in the upstream and midstream rather than just focusing on sanctioning deviant staff (downstream).</p

Targeting systems not individuals:Institutional and structural drivers of absenteeism among primary healthcare workers in Nigeria

Universal Health Coverage (UHC) can only be achieved if people receive good quality care from health workers, yet in Nigeria, as in many other low- and middle-income countries (LMICs), many health workers are absent from work. Absenteeism is a well-known phenomenon but is often considered as the self-serving behaviour of individuals, independent from the characteristics of health systems structures and processes and the broader contexts that enable it. We undertook a qualitative inquiry among 40 key informants, comprising health facility heads and workers, community leaders and state-level health policymakers in Nigeria. We employed a phenomenology approach to examine their lived experiences and grouped findings into thematic clusters. Absenteeism by health workers was found to be a response to structural problems at two levels –midstream (facility-level) and upstream (government level) – rather than being a result of moral failure of individuals. The problems at midstream level pointed to an inconsistent and unfair application of rules and regulations in facilities and ineffective management, while the upstream drivers relate mainly to political interference and suboptimal health system leadership. Reducing absenteeism requires two-pronged interventions that tackle defects in the upstream and midstream rather than just focusing on sanctioning deviant staff (downstream).</p

The Vehicle, 1969, Vol. 11 no. 1

Vol. 11, No. 1 Table of Contents PhotoJeff Nelsonpage 4 The Dancing BodLukepage 5 The Hide-OutEleanor Aikenpage 6 DrawingLawrence Unfriedpage 7 Rain-Drunk Midnight ManiaThomas W. Reapage 9 What I\u27m Supposed To Say About WarMichael G. McKeepage 10 Sinking LashesThomas W. Reapage 10 CandleThomas W. Reapage 10 Nervous ChaperoneThomas W. Reapage 10 Formless Beauty Left To DryThomas W. Reapage 10 MasqueradeThomas W. Reapage 10 Mad JohnJames Jonespage 11 Black RacistJames Jonespage 12 HandsLawrence Unfriedpage 13 The Real Jonathan T. WillwickCharles Whitepage 14 A Cold Afternoon In JanuaryCharles Whitepage 16 Crumpled PaperLawrence Unfriedpage 16 ImpressionMichael G. McKeepage 18 The HunterMary Ann Spidelpage 19 PhotoJeff NelsonCaptionMichael G. McKeepage 20https://thekeep.eiu.edu/vehicle/1019/thumbnail.jp