Workshop report Bergen 7.7.2009

By invitation of BTC, U4/CMI held a training workshop on corruption in the health sector on June 30 – July 1, 2009. The event was organized by Jeroen Michels(Governance Advisor). U4 was represented by Harald Mathisen (Senior Program Coordinator). The trainers were Taryn Vian (Assistant Professor) at the BostonUniversity, School of Public Health, and Dr. William Savedoff (Senior Partner) at Social Insight.

Overall there was excellent participation in the workshop. The audience included health experts, governance experts, and administrative staff from BTC, staff from the Ministry of Foreign Affairs, Institute of Tropical Medicine from Antwerp, NGOs and contractors implementing foreign aid projects. The mix of participant backgrounds and country experiences greatly enriched the discussion.

The workshop was held in English, which worked well as everyone spoke English and could understand presentations. When using small group discussions as a teaching method, it worked well to create single language groups. It may also be good to translate some of the handouts and case studies which will be read during class, so that people can skim/read quickly. For more lessons learned, see attachment 1.

The feedback from the participants is very positive, even if seen in a comparatively light (see attachment 2), and reflects well on U4’s observations of the proceedings. U4 would like to thank BTC for seamless pre-workshop organizing, for providing outstanding localities and for creating a positive learning environment.

U4 used the opportunity to engage key staff in discussions of how an ambitious practitioner’s network on corruption in the health sector could look like. A proposal for such a network will be presented at the U4 Steering Committee on October 1, 2009.

On behalf of U4/CMI and the team of trainers

Harald Mathisen,U4

Attachment1. Lessons Learnt

Day One

  • Exercises and case studies worked well. Starting exercise on “What is Corruption?” generated good discussion and got people participating right away.
  • Changed order of sessions in afternoon to start with Procurement and Pharmaceuticals Corruption, so that we would have adequate time for this important session. The presentation and discussion benefited from good participation from several people who had expertise in this area. Case work (Bulgaria case) was excellent.
  • Finished the day with the Polio Eradication Case study. For this one, we used single language groups, which was appreciated by participants and facilitated discussion. Discussion of Part A seemed to focus more on possible legitimate reasons for why one village had not been vaccinated, rather than on possible types of or reasons for corruption.
  • Gave homework (i.e. analyze the Absenteeism case studies, read Bed Nets for Obdura case). Many people did the homework, which allowed us to go faster in Day 2.

Day Two

  • Started with Absenteeism cases. Used a new teaching method which worked well. We didn’t use the Power Point, but instead went through each case to analyze the intervention, how it worked, what people thought would happen and what things they were worried about. Then gave the answers. Shortening this exercise seemed to improve it. Took 1 hrs.
  • Discussion brought up the question of the relationship between Absenteeism and Corruption. Some participants felt that absenteeism isn’t really corruption. There was good debate.
  • Informal Payments session took about 45 min. One participant had worked in Cambodia and knew the experience of TakeoProvincialHospital (a hospital that has worked to decrease informal payments). This was a helpful addition to the discussion.
  • After break, Bill did session on Budget Transparency and Civil Society Monitoring. One participant commented on the problems for transparency caused by lack of alignment of donor line items (for aid) and government line items. Another participant commented on the need to go beyond “web sites” and “PETS” as options for transparency and civil society participation. Bill clarified that these were just examples.

Attachment 2. Feedback

87% of participants found the workshop very useful.

67% of participants gained new information.

73% thought the workshop content matched the announced objectives.

53% thought the workshop was very or extremely relevant to their current work.

80% felt the workshop helped them identify new and useful sources of information.

100% of participants agreed that the interaction between participants and presenters was good.

93% of participants thought interaction among participants was good.

79% of participants thought the workshop length was good (some felt it was too short).

77% of participants felt the group activities were very useful.

80% felt the presentations were useful.

93% of participants would recommend this workshop to their colleagues.

Suggested additional topics for future workshops:

  • The effect of donor countries and NGOs on brain drain by hiring the best people of the Ministries by offering high salaries. Methods to be discussed on how to avoid that.
  • Monitoring and evaluation of anticorruption interventions in health programs.
  • How to act when corruption is discovered.
  • The position of donors. Is it desirable to make political statements or take positions at Embassy level?
  • Misuse of information (medical data – personal data).
  • The other side of the story: low salaries and staff needs to survive.
  • More subjects linked to the content of the Paris declaration (integrated projects, homogenousregulation).

General comments or suggestions:

  • Too short to cover all the issues. Extend length to 3 days at least (3 participants noted this).
  • More on how to identify address corruption risks and set priorities.
  • Expand corruption definition to include enablers/complicit organizations.
  • Should maybe focus on one country.
  • Would be ok to include more colleagues outside health sector, as much is not health specific.
  • Do follow-up after the workshop, to create a critical mass.
  • Encourage more participation of NGOs.