Submission ID 117043
| Issue/Objective | Ensuring access to medicines is a core component of quality healthcare, yet studies indicate poor medicine availability in low-resource settings, including Nigerian public health facilities. Amid the current global health funding crisis, optimizing investments is critical. Drug Revolving Funds (DRFs) are financing mechanisms which aim to ensure the supply of affordable, quality medicines. However, these mechanisms face risks of corruption, defined by Transparency International as "the abuse of entrusted power for private gain". This study investigates stakeholder perspectives about the drivers and barriers to corruption in DRF implementation in Kebbi State, Nigeria. |
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| Methodology/Approach | We conducted 12 semi-structured key informant interviews between November 2023 - October 2024 with public officials and health care workers involved with administering the DRF in Kebbi state Nigeria. Our interviews focused on learning about corruption drivers and anti-corruption, transparency and accountability (ACTA) mechanisms in place to mitigate corruption risks. Purposive sampling was used to recruit stakeholders involved in the design, implementation and evaluation of the DRF at the national, state and health facility levels. Analysis include descriptive statistics, inductive coding and deductive coding based on Vian's Framework of Corruption in the Health Sector. |
| Results | Key informants noted that corruption risks within the DRF structures were caused by financial pressures (e.g. pilfering of funds for political gain), opportunities to abuse (e.g. lack of adequate oversight) and rationalization (e.g. perception of funds as discretionary, justification of funds to supplement revenue). ACTA mechanisms identified include anti-corruption activities (e.g. implementation of standardized guidelines), transparency mechanisms (e.g. increasing community awareness), accountability practices (e.g., legislative authority to hold individuals/ organizations to account; empowering citizens' voices). Political buy-in and managers' attitude are also necessary for mitigating corruption. |
| Discussion/Conclusion | DRFs are vulnerable to corruption risks, especially in low-resources settings due to contextual economic pressures, perverse incentives and justification of misusing funds. Amid increasing global funding constraints, understanding corruption drivers and risks, can allow policymakers to implement structures and processes to mitigate corruption, and improve DRF implementation ensuring affordable, high-quality medicines for the public. |
| Presenters and affiliations | Tolu Ojo Institute of Health Policy and Evaluation, University of Toronto, Toronto, Ontario Joshua Odogwu Medicaid Foundation Samuel Alabi Medicaid Foundation Zainab Bagudu Medicaid Foundation Jillian Kohler Leslie Dan Faculty of Pharmacy, University of Toronto |
