Sometimes it’s the seemingly small, behind-the-scenes efforts that make all the difference.
And for something as complex and important as a health service, having effective and accountable governance is the difference between a service that is reliable and can do its job saving lives, and one that can’t.
That’s where projects like the Transparency International Health Initiative come in, led by a nonprofit called Transparency International that fights corruption all over the world, and across all sectors.
It does this by ensuring fair competition when contracts for goods and services are bought, for example, and by ensuring laws are in place to prevent politicians or businesses diverting money away from where it was intended for their own benefit.
It’s essentially an organisation that stands up for the community and stands against dodgy deals that only benefit a few individuals.
The flagship scheme of the initiative is called Open Contracting for Health — which is all about ensuring hospitals get the best deals when buying supplies, and that staff whose job it is to make stock purchases have the skills to do so.
It has received funding from UK Aid — the budget spent by the UK’s Foreign, Commonwealth, and Development Office (FCDO) to reduce extreme poverty worldwide — and has been working to strengthen health systems in Uganda, Zambia, Kenya, Nepal, and South Africa since 2018. The grant is due to finish by March 2021.
The overall aim of the project is to “improve health outcomes in partner countries and increase public trust in health services”, the Transparency International Health Initiative explains on its website.
Decisions made by administrators are actually hugely important to the mission of delivering health care. According to the World Health Organisation, 20-40% of health financing does not go towards improving the health of everyday people in low and middle income countries. This is partly because up to 25% of all money which is spent through procurement being lost to corruption, Transparency International explains.
The Open Contracting for Health Initiative stops this corruption by training health administrators to put out open calls for new contracts — and to use online systems to update the public on the process. It has also worked with local procurement officials to help them mitigate common corruption risks.
Through this work, the initiative has helped facilitate a diversity of suppliers bidding for health care contracts in each country.
They have also engaged local charities and journalists in the process too, helping to keep the bidding processes accountable in the long run — by training them to scrutinise deals and spot potential corruption. Local Transparency International branches have “collaborated with journalists, academics, and media agencies to build understanding and awareness of the importance of health sector transparency,” the group explains.
In Lira district, Uganda, a new “Government Procurement Portal” was set up online, so that everyone could see what the government was bidding for and what the budgets were.
Patrick Ebil, head of procurement in local government in Lira district told the Transparency International Health Initiative that since they have been publishing data online the “narrative around transparency is changing”.
“We are now able to receive many bids compared to what we had before,” Ebil said. “The law requires at least a minimum of three bidders but we now get like five or six providers for specific procurements. To us, that is a huge achievement.”
Repeat this achievement across the country, and across other low and middle income countries, and you get a better, more transparent, and more effective global health system.
This story is part of a new series from Global Citizen called “UK Aid Works” — a collection of stories about health care development projects supported by Britain’s aid budget, collated by Action for Global Health UK (AfGH), an influential membership network convening more than 50 organisations working in global health.
In September, the Department for International Development (DfID) merged with the Foreign Office (FCO) to form the Foreign, Commonwealth, and Development Office (FCDO). At a time when the future of poverty-focused aid is under threat, it’s crucial that we hold onto programmes like these that focus on the world’s most vulnerable people. These stories are about the types of initiatives that we must strive to protect. You can check out more stories like this here — and call on the foreign secretary to ensure that aid is transparent and accountable here.