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  • Title: Auditing Nicaragua's anti-corruption struggle, 1998 to 2009.
    Author: Arosteguí J, Hernandez C, Suazo H, Cárcamo A, Reyes RM, Andersson N, Ledogar RJ.
    Journal: BMC Health Serv Res; 2011 Dec 21; 11 Suppl 2(Suppl 2):S3. PubMed ID: 22375610.
    Abstract:
    BACKGROUND: Four social audits in 1998, 2003, 2006 and 2009 identified actions that Nicaragua could take to reduce corruption and public perception in primary health care and other key services. METHODS: In a 71-cluster sample, weighted according to the 1995 census and stratified by geographic region and settlement type, we audited the same five public services: health centres and health posts, public primary schools, municipal government, transit police and the courts. Some 6,000 households answered questions about perception and personal experience of unofficial and involuntary payments, payments without obtaining receipts or to the wrong person, and payments "to facilitate" services in municipal offices or courts. Additional questions covered complaints about corruption and confidence in the country's anti-corruption struggle. Logistic regression analyses helped clarify local variations and explanatory variables. Feedback to participants and the services at both national and local levels followed each social audit. RESULTS: Users' experience of corruption in health services, education and municipal government decreased. The wider population's perception of corruption in these sectors decreased also, but not as quickly. Progress among traffic police faltered between 2006 and 2009 and public perception of police corruption ticked upwards in parallel with drivers' experience. Users' experience of corruption in the courts worsened over the study period--with the possible exception of Managua between 2006 and 2009--but public perception of judicial corruption, after peaking in 2003, declined from then on. Confidence in the anti-corruption struggle grew from 50% to 60% between 2003 and 2009. Never more than 8% of respondents registered complaints about corruption.Factors associated with public perception of corruption were: personal experience of corruption, quality of the service itself, and the perception that municipal government takes community opinion into account and keeps people informed about how it uses public funds. CONCLUSIONS: Lowering citizens' perception of corruption in public services depends on reducing their experience of it, on improving service quality and access and--perhaps most importantly--on making citizens feel they are well-informed participants in the work of government.
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