Abstracts

80 and analysis of health services and financial performance in the Eastern Cape, North West, and Mpumalanga provinces, showed that the implementation of a monitoring system helped curb potential abuse and corruption. The study concluded that instead of restricting financial personnel as accountable for budgets and medical personnel as accountable for services, a system that brings both together for shared responsibility is essential to prevent corruption and enforce accountability (Collins, 2005). Financial data and service utilization statistics in procurement or provincial health systems help increase transparency and focus attention on areas most prone to corruption. Encourage Civic Participation— A Lesson from Brazil An essential component in any democratic government is active citizen participation. As the public becomes more educated and aware of governmental decisions, public officials will be held more accountable for their decisions. A well-informed public ensures that the government is truly acting on behalf of public and not private interest. A successful mechanism in mitigating corruption and encouraging effective monitoring is municipal health councils. In Brazil, these councils enable citizens to supervise and supply feedback on the country’s public health system. These councils are present in nearly all of Brazil’s municipalities and are legally empowered to examine public accounts, demand accountability, and influence how resources are spent. The existence of municipal councils correlated with reduction in the incidence of corruption in public health programs. This relationship is significant over time. With each additional year of a health council, corruption incidence is reduced by 2.1% from baseline values (Avelino, et al., 2013). However, the decentralization of power to council members comes with responsibility that they operate on behalf of the public. The success of health municipal councils relies on the assumption that local bureaucrats are qualified to make decisions with limited supervision from the central government and that it is easy to hold these officials accountable. Since South Africa has already established the Office of the Health Ombud, its role can be reinforced by having health commissioners in every province and municipality, like Brazil. With the health ombudsman engaging with health professionals and citizens, a broader coalition can be formed to pressure politicians to listen to citizen voices. Conclusion Corruption poses a serious threat to the lives of South Africans, who rely on a public health care system that is already under-resourced. With evidence showing the incompetence and venality of public officials in health departments, combined with a significant lack of accountability, calls for more government intervention to protect citizens’ rights to health care are louder than ever. Given existing racial and socioeconomic disparities, failing to uphold stricter accountability will continue to perpetuate these inequalities in future South African generations. Overall, the vulnerabilities in the South African public health sector are not amenable to a single solution; rather, the government must collaborate with all health system stakeholders, including providers and professional associations, to effectively reduce corruption in a comprehensive manner. Addressing corruption would improve the stewardship and management in the public health system and provide better health care for all South Africans.