HEALTH sector corruption has over the years been swept under the carpet and in most cases, citizens tend to turn a blind eye to its existence.
By Michael Gwarisa
However, evidence gathered by the Transparency International Zimbabwe (TIZ) indicate that health sector corruption comes in different facets and is an everyday occurrence and affects women the most.
Corruption is defined by Transparency International as the “Misuse of entrusted power for private gain.” Corruption in most cases occur when public officials who have been given authority and a goal which further the good, instead use their positions and power to benefit themselves and those close to them (Gupta, Gauri and Khemuri).
Unlike corporate or white collar corruption, health sector corruption may involve soliciting for favors from patients in-order to offer a service, health workers causing artificial shortages ofCorrutpion so as to force patients to buy from healthcare stuff and or friends, stealing and reselling of drugs among a host of others.
Parliamentary Portfolio Committee on Health Chair, Dr Ruth Labode said due to poverty, more women were forced to use their bodies as payment for health and health related services.
Corruption undermines economic development of a nation and perpetuate poverty. Majority of the poor in Zimbabwe are women, over 70 percent. The poor are more likely to be dependant on the Public Sector Services that is often depleted by corruption.
“Corruption in Public Hospitals procurement procedures always results in higher cost of service and may even lower the quality of services offered. Since women have less income, the relative impact of higher prices is greater on them. Political and administrative corruption increases gender inequalities, such as access for promotions to higher level positions for women,” said Dr Labode.
She added that women can be direct victims of corruption because of existing social, economic, political and Sexual inequalities but women were more affected by indirect corruption.
“An underfunded Health Sector characterised by shortages of Human Resources, drugs, diagnostic equipment patients’ food and hospital stationary is a conducive environment for corruption. The Ministry of Health Budget has consistently remained below 8% of the fiscus for the past five years, which is a far cry from the recommended Abuja Declaration of 15%.
“Poor remuneration of the Service Providers inevitably make them look for ways of supplementing their incomes at their work place. Sayings like “Idla lapho ebotshelwe khona” or “Inofura payaka sungirirwa’” are rampart in the health sector. Health workers either demand monetary or sexual bribes for services supposed to be for free.
“Stealing and reselling of drugs, syringes and patient’s food to the public is a common occurrence. Most times, there is abusing procurement procedures by conniving with suppliers to buy at very high cost compared to the market prices. This erodes the allocated funds before the expected time of use.”
Director Family Health in the ministry of Health and Child Care (MoHCC), Dr Benard Madzima said inequalities between men and women were increasing in Zimbabwe with female-headed households experiencing higher poverty levels, hence the abuse.
[pullquote]“The 2017 Young Adult Survey established that 26.7% of females and 26.2% of males aged between 18 and 24 years had experienced any violence (physical, sexual, and/or emotional) in childhood. Females reported more of sexual violence whilst males reported mostly reported physical violence.[/pullquote]
“Gender based violence is high among young women as approximately 35% of young women experience physical violence from their partner or former partner while 14% experience sexual violence. Most of them start experiencing violence from 15 years old and about 44% do not seek help to stop the violence – ZDHS 2015/6,” said Dr Madzima.
He added that due to the increasing GBV cases, more women in vulnerable positions were being forced to pay for health services using unconventional means such as sexual favors or bribes especially in disaster hit areas such as Cyclone Idai areas.
“You find that some abuse their positions of power just because women will be vulnerable. Instead of distributing aid or offering health services, some end up soliciting for sexual favours in return for services.
“This is the kind of corruption we are talking about in the health sector. Women due to their vulnerable positions, end up offering themselves for exchange of services.”
Transparency International Research and Advocacy Assistant, Samuel Matikiti said gendered corruption looks at how corruption in the health sector disadvantages another gender more than the other and according their researches, more women were at the receiving end of corruption.
“For the past years, as an organisation we carried out about three if not four researches that actually give light to what we call gendered corruption in Zimbabwe. We carried out a research in tertiary institutions and we discovered that there is a trend which revealed that for students to attain higher marks, they will be required to pay with sex as a form of currency.
“Women are disadvantaged and are not financially capacitated and they will be indirectly or directly forced to use sex as a form of currency. Turning to the health sector, you realise that women are not economically and socially empowered and that increases their vulnerability. Women don’t possess much in most African set ups so they will only transact using sex so that they access certain services,” said Matikiti.
TIZ also carried out a research in Chisumbanje which revealed that women do not have access or own land and women were forced to sleep with leaders in order to access land.
Meanwhile, Katswe Sisterhood Program Manager, Debra Mwase said gendered corruption was mainly being perpetrated against sex workers as health care providers at times deliberately withhold services just to get sexual favours from sex workers.
“The challenge with the system is that Pre-Exposure prophylaxes (PREP) and Post Exposure Prophylaxes (PEP) are not available on demand. You need a police report to access PEP to prove that a crime has been committed against you.
“Sex work is also criminalised. So these two factors, the criminalisation of sex work and the non availability of these drugs on demand create room for abuse of power by healthcare stuff. Either you are asked to extend a sexual favour or you are asked to pay for that service. I understand they are key population clinics but they are not enough,” said Mwase.
She added that women because of their biological make up and social status require to use health services more than men and they have low income and are unlikely to have money to pay bribes so end up not accessing services thereby negatively affecting their health.
