Challenges that have hindered the effectiveness of anti-corruption efforts in past decades have included the following:
Sectorial and preventive strategies to fight corruption need to be further strengthened to enhance the overall effectiveness of anti-corruption. A well-established approach to engage in prevention in a specific context is to conduct risk assessments, as addressing risks is one of the key components of prevention. In the field of anti-corruption, risk assessment can broadly be defined as the analysis and study of the likelihood and impact of specific corrupt acts for the purpose of mitigating them. It distinguishes itself from other corruption assessment approaches in that it focuses on the potential for – rather than the perception, existence or extent of – corruption.
Based on gaps in traditional anti-corruption approaches and building on its longstanding engagement with governments, civil society organizations and other partners on corruption prevention initiatives over the years, UNDP developed a comprehensive risk-based methodology to help advance countries’ corruption prevention efforts: the UNDP methodology for corruption risk management. Starting in 2016, it first piloted the approach in six countries and territories in the Middle East and North Africa. It continues to share lessons, develop tools and guidance, and train countries to implement risk-based approaches to corruption in other regions, in partnership with the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund), the World Health Organization (WHO) and the World Bank.
The framework uses a corruption risk assessment to help countries identify vulnerable “decision points” in the health system, or other sectors, based on the likelihood and impact of corruption at each point. The assessment is conducted through national multi-stakeholder teams. Following training on the methodology, country stakeholders are able to map decision points and identify respective stakeholders and action points through a function-based approach combined with process mapping. The resulting risk heat maps allow for prioritization of corruption risk mitigation measures and the development of a sectoral implementation plan.
The experiences implementing this approach to date have underscored that:
Additional benefits include the creation of a common language among stakeholders between and within sectors, the integration of health system strengthening efforts with specific programme needs and the promotion of country ownership.
This section provides a high-level overview of key steps in the process of applying UNDP’s corruption risk management approach, which can be adapted to different contexts and objectives. Full details on the activities, tools and concepts entailed in each step can be found in a forthcoming guide. A case study on the experience and lessons from Tunisia, the first country to roll out this approach and achieve results in the health sector in particular, can be found here. Additional guidance can be found in the webinar recordings in the key resources below. If you are a government partner or another stakeholder engaged in implementing a UNDP-supported health programme and would like to initiate this process in your country, please contact firstname.lastname@example.org for further information and guidance.
The scope can be developed through surveys, consultations, desk research, analyzing historical data and review of previous reports, national policies and/or prior corruption cases. During the scoping exercise, the context needs to be thoroughly understood and the criteria for risk evaluation have to be defined. The final stage of scoping is to identify the ‘decision/action points’ and generate a list, followed by defining the potential deviated decisions associated with each of them. To identify decision points, process mapping is used to follow the steps, decisions and actions in a routine workflow illustrated in a visual form. It can be used to simplify a process and facilitate breaking it down to reach the units of analysis that are decision/action points.
A prospective analysis is conducted to identify all potential corrupt acts and deviations that might take place around each decision/action point. A risk analysis is then conducted to assess the impact (significance) and likelihood (probability) of the corruption risks identified. After having determined ‘impact’ and ‘likelihood’, respective outcomes can be used to define the risk level (profile) of the decisions/action point. Decision/action points are assessed one by one to categorize each as low, medium, high or critical risk. The risk evaluation is based on pre-set criteria agreed during the scoping phase. Based on this assessment, the decision/action points are illustrated on a ‘risk heat map’ according to their risk profiles. The visual representation helps to facilitate further evaluation, prioritization and monitoring.
After the plotting of the different points on the heat map and the evaluation of the risks, the next step is to explore the different treatment options for the selected corruption risks. The trade-offs between the potential negative impact of a corruption risk and any potential damage that might happen because of the measures designed to control the risk should be carefully weighed. It is advisable to focus on controls that can mitigate risks of corruption while advancing performance and the achievement of health outcomes, minimizing waste and mitigating other governance related risks such as negligence and theft. Likewise, it is good to prioritize controls that can mitigate several corruption risks at several decision points, such as a software that can improve control over the whole supply chain.
Given resource limitations, a systematic prioritization process for risk treatment measures should be established based on evidence and preset criteria. The prioritization process should enable stakeholders to reach consensus on what decision/action points are the most important (politically, socially and/or economically), what response is the most feasible and what interventions will have the strongest positive impact. This paves the way for an actionable plan that is applicable within the country context and with the available resources.
Based on the results of the prioritization, a plan should be put in place to tackle the selected corruption risks and resources should be allocated and mobilized to implement the plan. This should be followed by implementation of interventions to address the risks. Certain baseline assessments need to be carried out as well.
Case Study: A Risk-based Approach to Tackle Corruption in the Health Sector | Lessons from Tunisia
United Nations Development Programme
Summary Report: Initial Findings for the Application of Managing Risks of Corruption in the Health Sector in Zimbabwe
Ministry of Health and Child Care, United Nations Development Programme
Conceptual Framework: Corruption Risk Assessment at Sectoral Level – Copy for Open Consultation and Peer Review
United Nations Development Programme
UNDP conducted two webinars in November and December 2020 – an introductory session and a more comprehensive training session – on the corruption on the methodology for corruption risk management in the health sector. The sessions primarily targeted UNDP country offices and government partners implementing health programmes, but the approach is relevant to broader audiences. The recordings and presentations from these sessions are available below.
Managing Corruption Risks in the Health Sector in COVID-19
Webinar recording (Video) | Webinar summary (PDF)
Webinar presentation (PDF): Methodology for Corruption Risk Management in the Health Sector