Vulnerabilities to Petty Corruption in Ghana’s Healthcare System: An Ethnographic Study

Corruption continues to be a major issue of global concern and discussions on the issue have escalated over the past two decades, prompting the Bretton Woods institutions and the donor community to tie development assistance to governance indicators. Accordingly, there is a growing shift among the research community toward a disaggregated corruption research due to the beguiling assumption that a reduction in grand corruption would have a knock-on effect on petty corruption. Ghana has a multiplicity of laws and policies aimed at tackling the menace of corruption in public service. Notwithstanding, corruption continues to be a major hindrance to national development efforts. Indeed, the country has been performing below average in the global Corruption Perception Index by Transparency International in the past decade. The study examines the drivers of petty corruption in the health sector through a field survey comprising two hundred respondents in five major referral hospitals across five regions, combined with key informant interviews and secondary sources. It finds informal payments as the main driver of petty corruption in the health sector, which is sustained by social norms and the desire to obtain preferential treatment occasioned by social pressures. The study discusses the implication for interventions such as the national health insurance scheme, which was designed to protect vulnerable groups against out-of-pocket payments for healthcare and concludes with directions for future research. Key words: Ghana, Corruption, Healthcare, Informal Payments, Value systems, Health insurance DOI: 10.7176/PPAR/12-1-05 Publication date: February 28th 2022