Role of social norms and institutional characteristics in driving corruption


Corruption in healthcare is widespread and consequential. Informal payments are a common form of petty corruption, especially in low- and middle-income countries. Using data from the Life in Transition Survey encompassing 33 countries across Europe and Central Asia, I analyze the prevalence and reasons behind informal payments made to public health providers. In addition to individual- and system-level factors often used in the literature, I also introduce a latent measure of social norms related to high levels of corruption. These are associated with a higher prevalence of making informal payments. This paper also bridges a gap between the corruption literature and health investigations of informal payments by introducing an analysis of why payments were made. I find that the association between health system characteristics and informal payments prevalence differs based on the reason for payment. This difference is further exacerbated by the existence of corruption-related social norms. The results of this analysis highlight the need to revisit existing anti-corruption policies. I test the robustness of the results by performing a Heckman correction analysis to control for missing data. 

Academic journal publications:

Parvanova, I. (2024). The effect of institutional characteristics and social norms on corruption in healthcare. Governance., 

Media coverage:

Doctor bribes: Romania finds rare success among persisting healthcare corruption across Europe by Vedrana Simičević, BMJ, [23 February 2024]