The report, Corruption Victimization Survey In Nigeria, has revealed that the most prevalent form of corruption that exists in the health care sector is the collection of financial tips from patients in the process of accessing health care. The study was carried out by TapNitiative for Citizens Development and Dataphyte.
The study also revealed other forms of corruption including inappropriate billing of patients without receipts, and diverting patients to their private practices. For instance, more than 80% of the surveyed residents of the FCT who used primary healthcare in Abuja were not issued receipts. The survey was conducted in sampled the six local government councils of the Federal Capital Territory as a pilot. The surveyed LGAs are Abaji, Abuja Municipal Area Council (AMAC), Bwari, Gwagwalada, Kuje, and Kwali local government areas. and
Speaking with newsmen in Abuja, the Executive Director of Tap Nitaitive for Citizens Development, Mr. Martin Obono, Esq said, “this research aims to investigate the extent to which citizens are victimized when they try to access healthcare facilities.”
Respondents, representing members of households in these LGAs were interviewed. Mr. Obono said, “the interview questions were formulated from four specific objectives which were driven by the initial research questions centred on determining the extent that patients tip healthcare workers to access health care services? what extent does health insurance cover for access to health care facilities? To what extent are patients deprived of health care service due to inadequate and ineffective health care facilities? Finally, to what extent are patients deprived of health services due to corrupt officials in health care facilities.”
Mr. Olufemi Joshua, the Chief Executive Officer of Dataphyte said, “the study should serve as a tip for the media and civil society organizations to carry out investigations to expose ways corruption manifests in the health care system. Most importantly, the result of this study will be important to citizens as it will encourage the sensitization of patients of their rights in accessing health care and reporting unruly behaviour of health workers to the right authority.”
The study showed that most common corrupt practices obtainable in the Nigeria health care system include offering bribes and tips, inappropriate billing of patients without receipts, and diverting patients to their private practices and these are all accepted as normal.
To answer the first research question, the study found out that in four hundred and forty-nine (449) transactions involving the services of paying for bed space, consultancy fee, HIV fee, tuberculosis fee, Hepatitis fee and movement of files, receipts were issued only eighty-three (83) times with three hundred and sixty (360) cases of non-issuance of receipts.
For bed space service, between 200 and 37,000 naira was paid by respondents in one-hundred and fifteen (115) cases. Although in 85% of the cases, payment was made to the cashier, only in 30 cases were receipts issued. Leaving 85 different cases where bed space service was paid for without the issue of a receipt.
One hundred and forty-seven (147) respondents attested to paying between 100 naira to 5000 naira for movement of their medical file. One hundred and forty-five (145) of these respondents noted that they were not issued receipts with only two of them claiming they were issued a receipt.
From the findings of this research question, this study concludes that since the
majority of the amount collected for the analyzed service is to the tune of 100 naira to 5000 naira and without receipts, they are tips. is invalidates the null hypothesis that patients do not have to tip health workers to access health facilities.
Findings from the study show that 73 of the 300 respondents sampled were enrolled in an NHIS scheme. 52 of them enrolled in a government insurance scheme while the other 21 are enrolled in a private insurance scheme.
The analysis shows that 95% of the services the respondents paid for, was outside their NHIS cover. The purchases made were for drugs not available in the pharmacy of the health care facility. This amount ranges between 500 naira to 7000 naira. Despite the extra amount the respondents pay outside their NHIS scheme, the respondents think that being on NHIS has been beneficial. As such, findings from this research show that 95% of the times NHIS does not cover the amount for the drugs that are prescribed for the respondent.
Part of the research showed that 65% of the respondents were denied service due to the lack of adequate medical facilities such as doctors, bed space, blood for transfusion, and the inability to treat a patient’s condition. The other 35% of the time, services were denied to respondents due to the inability of the respondents to provide payment before treatment. Thirty times when service was denied by the respondents, they were referred to another hospital.
The distribution of this referral is even with 15 referrals made to public health facilities and the other 15 going to private hospitals. 95% of the times such referrals were made, the patients received treatment in the health facility they were referred to.
Furthermore, the respondents rated the available health facilities and health workers as 37% moderate, 23% good, 17% poor, 10% very good.
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