Anti-corruption, Transparency and Accountability: Case Study of Healthcare in the Arab Countries

Background: The Arab states suffer from high levels of corruption. The UNDP’s team there developed an approach to tackle corruption and enhance transparency and accountability in healthcare as part of its broader efforts to support the Sustainable Development Goals. This work evolved into a proper tool, the Conceptual Framework for Corruption Risk Assessment at Sectoral Level (hereafter ‘Framework’), with implementation guides that enable tailoring to sector and country context. Objectives: This article documents the development of the Framework, its methodology and observed added value. Methods: Qualitative methods were utilized comprising desk research, field experience, stakeholder outreach, and focus group observation and documentation. It was most appropriate because the objective was to develop a methodology with specific characteristics. Results: The new approach uses anti-corruption as an explicit entry point to governance reforms. It articulates a structured evidence-based method to apply risk management methodology – tailored to the specificities of corruption as a risk – in healthcare whereby assessment and mitigation are (a) within institutions (b) focused on decision points and (c) around transactions while bringing together health and anti-corruption communities towards designing measurable results-oriented reforms. Conclusions: The Framework may be effective in driving concrete governance reform efforts that demonstrably reduce corruption by means of creating a common language and agenda among different stakeholders, changing the mindset towards reform, and developing targeted solutions with higher return on investment. As such, it may be capable of generating observable and sustainable progress towards healthcare reform.