Improving Basic Healthcare Service Delivery in Cameroon by Promoting Innovative Whistle-blowing Techniques
The project aimed to reinforce transparency, accountability, participation and integrity in public hospitals in Cameroon by raising patient awareness of healthcare rights and providing an independent mechanism to report instances of corruption.
A new digital reporting platform was developed and piloted by TI-Cameroon in partnership with Afro-Leadership and a group of hospitals.
An initial survey provided insight into the most effective ways for raising awareness amongst patients and encouraging whistleblowing. For example, patients highlighted their preference for using SMS and a digital platform/website to receive information and to submit complaints. For poor communities, where access to the internet is difficult, the preference is for a manual, paper-based reporting mechanism, with outreach support for villages.
The launch strategy involved media engagement, which led to widespread radio and TV articles about the initiative. This served to further sensitise members of the general public about healthcare rights.
An evaluation at the end of the pilot involved an experience-sharing workshop with healthcare workers, patients and representatives from the Ministry of Health.
In 2010, Cameroon’s National Anti-corruption Commission (CONAC) evaluated the intensity of corruption in public hospitals at 8/10, which was exceptionally high. Among the causes for the high score was a weak whistle-blowing mechanism.
- New online and SMS whistle-blowing platform developed in collaboration with Cameroon healthcare sector. Trial & implement new approach
- Public sensitization campaign sessions to raise awareness of patient rights, including the right to report corruption.Awareness raising
- Hospital Directors trained on measures to remedy corruption situations in hospitals. Implementation of new policy & practice
- The project generated a total of 228 corruption reports over a six month period.
- Hospital Directors were able to identify the most corrupt services. For example, in the Biyem-Assi District, 50% of all reports related to the Hospital’s maternity service.
- Across the entire project, the services receiving the most complaints included: emergency units (42% of reports), paediatrics (25%) and maternity services (17%).
- Hospital Directors were able to identify how corruption was manifesting within services. For example, 61% of complaints related to fraud and 35% to bribery.
Following the pilot period, TI-Cameroon is working with the Ministry of Health to sustain the project.
- A portion of patients were found to be illiterate and in need of support from outreach staff to submit reports. Many people in poorer communities are also unable to afford mobile phones and require access to a more traditional paper-based system.
- Raising awareness of patient rights should include awareness of the latest costs of healthcare services and medicines, as this will help to combat informal payments.
- It is important to gather case studies about the positive impacts of reporting, so that communities can see the practical difference it can make.