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Rising bribes: accessing public health services in Northern Cyprus during COVID-19

Year 2024, Volume: 22 Issue: 1, 102 - 111, 26.04.2024

Omer Gokcekus

https://doi.org/10.20518/tjph.1388669

Abstract

Objective: This study investigates the impact of the COVID-19 pandemic on informal payments (bribes) in accessing public health services. It assesses whether the pandemic increased informal payments and whether vulnerable populations, namely women, migrants, and low-income individuals, were more susceptible to bribery.
Methods: Data from pre-pandemic (2019) and pandemic (2021) Global Corruption Barometer surveys in Northern Cyprus were statistically analyzed to examine changes in informal payments and their associations with gender, income, and immigrant status.
Results: The study revealed a significant surge in informal payments for accessing public health services during the COVID-19 pandemic. In 2019, before COVID-19 pandemic, 4.70% of respondents reported paying bribes. However, in 2021, during COVID-19 pandemic, this figure spiked to 17.85%, with an odds ratio of 4.062 underscoring the magnitude of the increase. Moreover, during COVID-19 pandemic, women reported higher bribe rates (20.3%) compared to men (13.7%), migrants had substantially higher bribe rates (25.7%) than natives (15.7%), and individuals with lower incomes (25.6%) were more inclined to engage in bribery. Marginal effects, based on logistic regression estimation results, showed that migrants had a 9.63 percentage points higher likelihood of bribery, low-income individuals had a 12.57 percentage points higher probability, and being female was associated with a 9.05 percentage points higher chance of engaging in bribery.
Conclusion: This study highlights a troubling surge in bribery within the public health sector during the COVID-19 pandemic. Vulnerable populations, especially women, migrants, and low-income individuals, face increased risks. Urgent action is needed to combat corruption in healthcare during pandemics and ensure equitable access to healthcare services.

Keywords

VID-19 Bribes Public Health Vulnerable Groups Northern Cyprus

References

  • Wolf K. Making the Link Between Health and Productivity at the Workplace – A Global Perspective. Industrial Health. 2010;48(3):251-255.
  • Wagner C. Health and Happiness. Futurist. 2004;38(1):10.
  • Allin S, Davaki K, Mossialos E. Paying for “Free” Health Care: The Conundrum of Informal Payments in Post-Communist Europe. Transparency International Global Corruption Report. 2006;63-75.
  • Hutchinson E, Balabanova D, McKee M. We Need to Talk About Corruption in Health Systems. Int Journal of Health Policy and Management. 2019;8(4):191-194.
  • García P. Corruption in Global Health: The Open Secret. The Lancet. 2019;394(10214):2119-2124.
  • Horodnic AV, Williams CC, Drugă RI, Incaltarau C. Informal Payments by Patients in Central and Eastern Europe during the COVID-19 Pandemic: An Institutional Perspective. Int Journal of Environ Res and Public Health. 2021;18(20):10914.
  • Tamin J, Samuel O, Suraya A, Ebuenyi ID, Naicker N, Rajput-Ray M. Vulnerable Workers and COVID-19: Insights from a Survey of Members of the International Commission for Occupational Health. Int Journal of Environ Res and Public Health. 2021;18(1):346.
  • Stepurko T, Pavlova M, Gryga I, Groot W. To Pay or Not to Pay? A Multicountry Study on Informal Payments for Health-Care Services and Consumers’ Perceptions. Health Expectations. 2015;18(6):2978–93.
  • Matsushima M, Yamada H. Impacts of Bribery in Healthcare in Vietnam. The Journal of Development Studies. 2016;52(10):1479-1498.
  • Szende A, Culyer AJ. The Inequity of Informal Payments for Health Care: The Case of Hungary. Health Policy. 2006 ;75(3):262–71.
  • Tambor M, Pavlova M, Golinowska S, Sowada C, Groot W. The Formal–Informal Patient Payment Mix in European Countries. Governance, Economics, Culture or All of These?. Health Policy. 2013 ;113(3):284–95.
  • Gaal P, Belli PC, McKee M, Scócska M. Informal Payments for Health Care: Definitions, Distinctions, and Dilemmas. Journal of Health Politics, Policy and Law. 2006 ;31(2):251–93.
  • Tham E. In COVID China, a Hospital Bed Can Hinge on Who You Know, Red Packets. Reuters [online]. 2023 Feb 14. Available at: https://www.reuters.com/world/china/covid-china-hospital-bed-can-hinge-who-you-know-red-packets-2023-02-14/. Accessed Feb 25, 2023.
  • Salmon J, Satoğlu EB. Science, Market, and Politics: How Corruption Is Manifesting in the Covid-19 Pandemic. Rutgers Business Review. 2022;7(1):45-60.
  • Balabanova D, McKee M. Understanding Informal Payments for Health Care: The Example of Bulgaria. Health Policy. 2002;62(3):243–73.
  • Molla AA, Chi C. Who Pays for Healthcare in Bangladesh? An Analysis of Progressivity in Health Systems Financing. Int Journal for Equity in Health. 2017;16(1):167.
  • Ensor T. Informal Payments for Health Care in Transition Economies. Social Science & Medicine. 2004;58(2):237–246.
  • Belli P, Gotsadze G, Shahriari H. Out-of-Pocket and Informal Payments in Health Sector: Evidence from Georgia. Health Policy. 2004;70(1):109–123.
  • Sonan S, Gokcekus O. The Northern Part of Cyprus: Corruption Barometer 2019 [online]. 2020. Available at: https://online.fliphtml5.com/degtj/uwug/. Accessed October 25, 2022.
  • Sonan S, Gokcekus O. The Northern Part of Cyprus Corruption Barometer 2021 [online]. 2022. Available at: https://online.fliphtml5.com/degtj/zkir/#p=1. Accessed October 25, 2022.
  • Gokcekus, O, Sonan S. Corruption Perceptions in Northern Cyprus: 2022 Report [online]. 2023. Available at: https://library.fes.de/pdf-files/bueros/zypern/20360.pdf. Accessed February 2, 2024.
  • Williams CC, Horodnic AV. Rethinking Informal Payments by Patients in Europe: An Institutional Approach. Health Policy. 2017;121:1053-1062.
  • Lewis M. Informal Payments and the Financing of Health Care in Developing and Transition Countries. Health Affairs. 2007;26(4):984-997.
  • Rahmioglu, N, Naci, H, & Cylus, J. Improving health care services in Northern Cyprus: A call for research and action. European Journal of Public Health. 2012;22(6): 754–755.
  • Abuduxike G, Aşut Ö, Vaizoğlu SA, Cali S. Health-Seeking Behaviors and its Determinants: A Facility-Based Cross-Sectional Study in the Turkish Republic of Northern Cyprus. Int J Health Policy Manag. 2020; 9(6):240-249.
  • Arasli, H, Ekiz, H, & Katircioglu, T. International journal of health care quality assurance. International Journal of Health Care Quality Assurance. 2008; 21(1): 8-23.
  • Arasli, H, & Ahmadeva, L. No more tears! A local TQM formula for health promotion. International Journal of Health Care Quality Assurance. 2004; 17(3): 135-145.
  • Ruzanov RM. Zharlygassinov TM. Corruption in the Healthcare Sector During the Covid-19 Pandemic: Causes, Consequences and Responses. Economics: the Strategy and Practice. 2021;16(3):217-226.
  • Atanasova E, Pavlova M, Moutafova E, Rechel B, Groot W. Out-of-pocket Payments for Health Care Services in Bulgaria: financial burden and barrier to access. European Journal of Public Health. 2012;23(6):916-922.
  • Feng Y. The Global Heath Community Needs Innovation and Reform. The Lancet Global Health. 2020;8(3):325-326.
  • Vian T, Brinkerhoff DW, Feeley FG, Salomon M, Kieu Vien NT. Confronting Corruption in the Health Sector in Vietnam: Patterns and Prospects. Public Administration and Development. 2012;32(1)49-63.
  • Dikmen S, Çiçek HG. Fighting against Corruption and Bribery in Public Procurements during the Covid-19 Pandemic. In: McGee RW, Benk S, editors. The Ethics of Bribery: Theoretical and Empirical Studies. Switzerland: Springer; 2023. p. 309-328.

Year 2024, Volume: 22 Issue: 1, 102 - 111, 26.04.2024

Omer Gokcekus

https://doi.org/10.20518/tjph.1388669

Abstract

References

  • Wolf K. Making the Link Between Health and Productivity at the Workplace – A Global Perspective. Industrial Health. 2010;48(3):251-255.
  • Wagner C. Health and Happiness. Futurist. 2004;38(1):10.
  • Allin S, Davaki K, Mossialos E. Paying for “Free” Health Care: The Conundrum of Informal Payments in Post-Communist Europe. Transparency International Global Corruption Report. 2006;63-75.
  • Hutchinson E, Balabanova D, McKee M. We Need to Talk About Corruption in Health Systems. Int Journal of Health Policy and Management. 2019;8(4):191-194.
  • García P. Corruption in Global Health: The Open Secret. The Lancet. 2019;394(10214):2119-2124.
  • Horodnic AV, Williams CC, Drugă RI, Incaltarau C. Informal Payments by Patients in Central and Eastern Europe during the COVID-19 Pandemic: An Institutional Perspective. Int Journal of Environ Res and Public Health. 2021;18(20):10914.
  • Tamin J, Samuel O, Suraya A, Ebuenyi ID, Naicker N, Rajput-Ray M. Vulnerable Workers and COVID-19: Insights from a Survey of Members of the International Commission for Occupational Health. Int Journal of Environ Res and Public Health. 2021;18(1):346.
  • Stepurko T, Pavlova M, Gryga I, Groot W. To Pay or Not to Pay? A Multicountry Study on Informal Payments for Health-Care Services and Consumers’ Perceptions. Health Expectations. 2015;18(6):2978–93.
  • Matsushima M, Yamada H. Impacts of Bribery in Healthcare in Vietnam. The Journal of Development Studies. 2016;52(10):1479-1498.
  • Szende A, Culyer AJ. The Inequity of Informal Payments for Health Care: The Case of Hungary. Health Policy. 2006 ;75(3):262–71.
  • Tambor M, Pavlova M, Golinowska S, Sowada C, Groot W. The Formal–Informal Patient Payment Mix in European Countries. Governance, Economics, Culture or All of These?. Health Policy. 2013 ;113(3):284–95.
  • Gaal P, Belli PC, McKee M, Scócska M. Informal Payments for Health Care: Definitions, Distinctions, and Dilemmas. Journal of Health Politics, Policy and Law. 2006 ;31(2):251–93.
  • Tham E. In COVID China, a Hospital Bed Can Hinge on Who You Know, Red Packets. Reuters [online]. 2023 Feb 14. Available at: https://www.reuters.com/world/china/covid-china-hospital-bed-can-hinge-who-you-know-red-packets-2023-02-14/. Accessed Feb 25, 2023.
  • Salmon J, Satoğlu EB. Science, Market, and Politics: How Corruption Is Manifesting in the Covid-19 Pandemic. Rutgers Business Review. 2022;7(1):45-60.
  • Balabanova D, McKee M. Understanding Informal Payments for Health Care: The Example of Bulgaria. Health Policy. 2002;62(3):243–73.
  • Molla AA, Chi C. Who Pays for Healthcare in Bangladesh? An Analysis of Progressivity in Health Systems Financing. Int Journal for Equity in Health. 2017;16(1):167.
  • Ensor T. Informal Payments for Health Care in Transition Economies. Social Science & Medicine. 2004;58(2):237–246.
  • Belli P, Gotsadze G, Shahriari H. Out-of-Pocket and Informal Payments in Health Sector: Evidence from Georgia. Health Policy. 2004;70(1):109–123.
  • Sonan S, Gokcekus O. The Northern Part of Cyprus: Corruption Barometer 2019 [online]. 2020. Available at: https://online.fliphtml5.com/degtj/uwug/. Accessed October 25, 2022.
  • Sonan S, Gokcekus O. The Northern Part of Cyprus Corruption Barometer 2021 [online]. 2022. Available at: https://online.fliphtml5.com/degtj/zkir/#p=1. Accessed October 25, 2022.
  • Gokcekus, O, Sonan S. Corruption Perceptions in Northern Cyprus: 2022 Report [online]. 2023. Available at: https://library.fes.de/pdf-files/bueros/zypern/20360.pdf. Accessed February 2, 2024.
  • Williams CC, Horodnic AV. Rethinking Informal Payments by Patients in Europe: An Institutional Approach. Health Policy. 2017;121:1053-1062.
  • Lewis M. Informal Payments and the Financing of Health Care in Developing and Transition Countries. Health Affairs. 2007;26(4):984-997.
  • Rahmioglu, N, Naci, H, & Cylus, J. Improving health care services in Northern Cyprus: A call for research and action. European Journal of Public Health. 2012;22(6): 754–755.
  • Abuduxike G, Aşut Ö, Vaizoğlu SA, Cali S. Health-Seeking Behaviors and its Determinants: A Facility-Based Cross-Sectional Study in the Turkish Republic of Northern Cyprus. Int J Health Policy Manag. 2020; 9(6):240-249.
  • Arasli, H, Ekiz, H, & Katircioglu, T. International journal of health care quality assurance. International Journal of Health Care Quality Assurance. 2008; 21(1): 8-23.
  • Arasli, H, & Ahmadeva, L. No more tears! A local TQM formula for health promotion. International Journal of Health Care Quality Assurance. 2004; 17(3): 135-145.
  • Ruzanov RM. Zharlygassinov TM. Corruption in the Healthcare Sector During the Covid-19 Pandemic: Causes, Consequences and Responses. Economics: the Strategy and Practice. 2021;16(3):217-226.
  • Atanasova E, Pavlova M, Moutafova E, Rechel B, Groot W. Out-of-pocket Payments for Health Care Services in Bulgaria: financial burden and barrier to access. European Journal of Public Health. 2012;23(6):916-922.
  • Feng Y. The Global Heath Community Needs Innovation and Reform. The Lancet Global Health. 2020;8(3):325-326.
  • Vian T, Brinkerhoff DW, Feeley FG, Salomon M, Kieu Vien NT. Confronting Corruption in the Health Sector in Vietnam: Patterns and Prospects. Public Administration and Development. 2012;32(1)49-63.
  • Dikmen S, Çiçek HG. Fighting against Corruption and Bribery in Public Procurements during the Covid-19 Pandemic. In: McGee RW, Benk S, editors. The Ethics of Bribery: Theoretical and Empirical Studies. Switzerland: Springer; 2023. p. 309-328.
There are 32 citations in total.

Details

Primary Language English
Subjects Health Care Administration, Health Services and Systems (Other)
Journal Section Original Research
Authors

Omer Gokcekus 0000-0001-8109-5918

Early Pub Date April 20, 2024
Publication Date April 26, 2024
Submission Date November 9, 2023
Acceptance Date February 8, 2024
Published in Issue Year 2024 Volume: 22 Issue: 1

Cite

APA Gokcekus, O. (2024). Rising bribes: accessing public health services in Northern Cyprus during COVID-19. Turkish Journal of Public Health, 22(1), 102-111. https://doi.org/10.20518/tjph.1388669
AMA Gokcekus O. Rising bribes: accessing public health services in Northern Cyprus during COVID-19. TJPH. April 2024;22(1):102-111. doi:10.20518/tjph.1388669
Chicago Gokcekus, Omer. “Rising Bribes: Accessing Public Health Services in Northern Cyprus During COVID-19”. Turkish Journal of Public Health 22, no. 1 (April 2024): 102-11. https://doi.org/10.20518/tjph.1388669.
EndNote Gokcekus O (April 1, 2024) Rising bribes: accessing public health services in Northern Cyprus during COVID-19. Turkish Journal of Public Health 22 1 102–111.
IEEE O. Gokcekus, “Rising bribes: accessing public health services in Northern Cyprus during COVID-19”, TJPH, vol. 22, no. 1, pp. 102–111, 2024, doi: 10.20518/tjph.1388669.
ISNAD Gokcekus, Omer. “Rising Bribes: Accessing Public Health Services in Northern Cyprus During COVID-19”. Turkish Journal of Public Health 22/1 (April 2024), 102-111. https://doi.org/10.20518/tjph.1388669.
JAMA Gokcekus O. Rising bribes: accessing public health services in Northern Cyprus during COVID-19. TJPH. 2024;22:102–111.
MLA Gokcekus, Omer. “Rising Bribes: Accessing Public Health Services in Northern Cyprus During COVID-19”. Turkish Journal of Public Health, vol. 22, no. 1, 2024, pp. 102-11, doi:10.20518/tjph.1388669.
Vancouver Gokcekus O. Rising bribes: accessing public health services in Northern Cyprus during COVID-19. TJPH. 2024;22(1):102-11.
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