Sectoral Risk Assessment in Sri Lanka
About the chapter:
Transparency International Sri Lanka (TISL) is a National Chapter of Transparency International (TI), the leading global movement against corruption. TI raises awareness of the damaging effects of corruption and works with partners in government, business and civil society to develop and implement effective measures to tackle it.
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Theory of Change
The Sustainable Development Goal 3 concerning health was viewed from 3 different dimensions; mapping of the different stakeholders in the particular sector, identifying the types of corruption and the most prevalent practices of corruption in the sector, identifying gaps in the legal framework.
Four Sustainable Development Goals - Health, Education, Gender and Climate Change were assessed through the lens of corruption to identify and provide an overview of risk that may hinder the achievement of these goals in Sri Lanka.
Each Goal were viewed from three dimensions:
• Mapping of the different stakeholders in the particular sector
• Identifying the types of corruption and the most prevalent practices of corruption in the sector.
• Identifying gaps in the legal framework
The methodology employed in this assessment comprised of the following steps:
• A literature survey – this involved a review of published journals, articles, research papers, electronic media and websites.
• Preliminary Stakeholder Discussions
• Discussions with specific sector stakeholders discussing and sharing their experience and views on the topics mentioned below.
• How does corruption happen in their respective sector?
• What are the most prevalent practices of Corruption?
• What are the risk hot-spots/most prevalent area which corruption occurs in the sector?
• What are the gaps in the legal framework?
Interviews with experts in the selected sectors – this involved four extended interviews with an expert in each sector.
• Health Sector – President of a prominent health sector association.
Preliminary Stakeholder Discussions were conducted in two events organized by Transparency International Sri Lanka. Stakeholders from each sector were invited
in order to discuss the aforementioned topics to gather relevant data. The data which was gathered through the steps explained above was reviewed by the Transparency
International Secretariat (TIS) and comments and suggestions were provided on the findings.
The data which was gathered through the steps explained above was reviewed by the Transparency International Secretariat (TIS) and comments and suggestions were provided on the findings.
- Corruption take place in a subtle but systematic way on a daily basis in the health sector. The most prevalent forms of corruption include informal payments by patients to service providers; absenteeism (workers who are legitimately on a payroll but are chronically absent without approval); ghost workers (non-existent individuals receiving salaries through the payroll system); reimbursement fraud (requesting insurance payments for services not rendered); dual practice (clinicians with salaries in the public sector who also maintain a private practice to divert patients or resources for their own financial gain); and improper marketing (promoting a drug for a clinical indication that is not approved for use; misleading marketing claims).
- Moreover, types of corruption in the health sector can also occur across multiple dimensions. According to Transparency International’s findings there are eight key areas of susceptibility: (i) health-systems governance; (ii) health-systems regulation; (iii) research and development; (iv) marketing; (v) procurement; (vi) product distribution and storage; (vii) financial and workforce management; and (viii) delivery of healthcare services (Petkov and Cohen, 2016).
TI Sri Lanka presented the findings and identified indicators to the relevant stakeholders in each sector including the Government Institutions and Civil Society Organisations and advocate to integrate the indicators to capture progress against corruption and achieve policy improvements in the health sector.