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1.Disseminate information – every change start within person, giving the knowledge and information to changing attitude and behavior on corruption and also increase addressing skill on corruption.
2.Improve detection and enforcement – after all personnel has skill to address corruption within organization, this issue is about how to build confident of personnel to report every corrupted actions. The enforcement and punishment of corrupted act must be appropriate and equity.
3.Increase transparency and accountability – transparency and accountability are how to manage organization clearly and could tracing every action and decision without any influence from everything.
4.Reduce monopolies – monopoly destroy transparency in organization. It easy to make corrupted action or decision within influence of some benefits. Reducing monopolies not only reduce corrupted act but also improve quality of product to appoint in organization, and generate benefit to customers. -
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I agree with the authors in a recommendation to fight against corruption in healthcare and I would like to point out some aspect about bribery in the healthcare system. As the authors have provide some cultural influence in the system, in many asian culture, it is a very common for the patients to give the presence or gift to the healthcare worker because we thought it’s good custom that nobody could harm while this cultural phenomenon didn’t appear in the western society.
However, this could let to exploitation of the system, for example, in Thailand, there’s a annenatal care system and government has grant basic access to every pregnant mother but some obstetrician exploited this system by established antenatal clinic where wealthy pregnant mother can chose to receive “special care”. The problem existed when obstetrician received money from the patients disguised as “gift” while using public resources to perform check up on their personal patients. Some of this special requirements from mothers even led to infant harmness such as perform Cesarean section without indication because the parents want their baby to be born in a specific time and date according to their belief. Since the hospital delivery room is a limited resources, the obstetrician tend to using their influence to book a room according to their schedule while others has to waited just because they didn’t give “gift” to their doctor.
In my opinion, we need to established law that restrict healthcare employee received any gift from patients to cut down their influence on the healthcare system.
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Corruption is the major problem in many organization both public and private sector. The definition of corruption is unclear in some situation. I think the corruption can not be eradicated but can be taper. My opinion in the four recommendation in the article.
1.Convene key stakeholders in the health system to seek agreement on the scale and nature of corruption in each health system. : This recommend can not success in corruption society because they not accept in the agreement that break their benefit.
2. Prioritize action. I think this process vary by experience from stakeholders, some view was the health system, some view was only in some process or unit. Key of this process is what is the true priority.
3. Take a holistic view. Same as the second recommendation, It’s difficulty to find the best holistic view.
4. Sets out what it can offer. I think this recommend not useful for inhibit corruption. Now I think society know that corruption was in every organization from small to large organization then the publication may not useful.
I think the corruption can be tapering by surveillance system. The data that record in many database can be analyze to pick up the corruption such as in the buying system of the government, the specific buying method can be used under 500,000 baht if the buying statement nearly 500,000 baht this is the clue of corruption. By this condition in database system can create corruption surveillance system in health system. The condition of clue of the corruption is the new solution to detection and can inhibit the corruption.
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1.Convene key stakeholders: Although having a stakeholder meeting Problems with operation or management Will still happen.
2.The necessary prioritize action: Prioritize to select that deal. I think I can do it at the same time. Because it was a damaging matter.
3.It the essential to take a holistic view: Holistic view operation It’s too general May not meet the desired issue.
4.it is important that the research community sets out what it can offer: It is something that needs to be done to reflect on what happened.I agree with the These articles are all about corruption.
In my opinion, Coping with corruption can be done through open data. To achieve public inspection Such as purchasing drugs in hospitals. -
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The author suggested 4 steps to against corruption and initiate a debate on corruption in health system. I personally think that these steps are similar to participatory action research that emphasizes participation and action. It seeks to understand and address the problems by trying to change it, collaboratively and following reflection. Also using research dissemination to amplify knowledge and impact to against corruption. Which I do agreed. However, I also think promoting accountability and transparency in health system can address corruption. Moreover, promoting moral intelligence among population especially in young people is important. Moral intelligence is the capacity to understand right from wrong and to behave based on the value that is believed to be right. You can’t teach an old dog new tricks but new generation is coming. They are our future to against corruption.
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According to the four steps to fight corruption in health system, I agree with all of these. All of four, meeting the stakeholder to seek agreement, prioritize and develop pragmatic action, take a holistic view, and sets out what it can offer, look like ideal of resolution plan of this problem. It very good idea and if it is possible, may can reduce percent of corruption in the system. In the other hand, like Mr.Wachirawit answer, the corruption problem in Asia is a culture related problem which more complex than western countries. In addition from ‘the gift’, eastern culture also in the part of patronage system which have been normalized in our society. I think it is challenge issue to solve the corruption problem in Thailand.
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After reviewing the provided article “We Need to Talk About Corruption in Health Systems” by Eleanor Hutchinson and et. al. I do agree with the four recommendation points to fight the corruption by following explanations:
– We (Health system) should do more researchs about the corruption in health system to understand what practices that is (are) or likely to be the corruption and this should be in the holistic view to collect all factors.
– The research/ study results as above mentioned would help or support to give the suitable definition of the corruption in each setting. Then we can priorities action.
Yes, I do agree with their recommendations. However, in my opinion, I would say that corruption is quite difficult to define for all health settings and corruption can be occurred in all parts of health system. It can be occurred in many ways with intentional performance; for example; in the procurement of supplies or drugs in hospitals and public sector that need to may like the extra-additional from general bid auction or in case of close relationship with requestor in that unit/department. Even for unintentional performance like receiving the luxurious gifts for special occasions e.g. Birthday or New Year. Or inviting to attend the party dinner. In some work unit, it is quite like the normal behaviors/ work cultural that we need to follow by the colleagues or even our supervisor. So, it is quite difficult if you can speak out this issue that occur in your workplace.
Everyone know that corruption is difficult to destroy but we could able to limit or inhibit. To fighting with the corruption, we can’t do it alone. We are strongly need the Teamwork collaboration. We need to begin by making the policy about preventive the corruption in your work. This policy must be the agreement in all level of staffs and make it as agreement with your partners and stakeholders. The policy needs to begin with how about the criteria and definition of “corruption” in your work. Sometimes, the people may not understand well about this and tend to do it as routinely, and then it will affect to unintentional corruption as explained above. Then, we need to create the policy that explain how impact of these corrupt activities if it is happened in your work. After we have the agreement/ policy, one step that should be do is TRAINING to let everyone clearly understand. Next, we should have the monitoring system to check/ monitor at all processes for any corruption may occur. Finally, we should have the clear actions/ punishment to any occurrences. So, we can use PDCA/PDSC (Plan, Do, Check/Study, Act) process to fight with the corruption problem. -
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Corruption is indeed a major problem worldwide, especially in developing countries. In Thailand, the definition of corruption may unclear in some scenarios. This article mentioned the four possible ways to address corruption. However, certain ways could not be done in Thailand and some other countries. For example, convene key stakeholders, some corruption occurs from the CEO level or high administration person, not from the operation staff and the agreement seems to be only the organization event…
I agree that if we try to follow the ideas addressed, corruption may be reduced. In my opinion, to coping corruption, educating about fighting and denying corruption will be taught in primary school and also PH curriculum as well. Moreover, morals and transparency will be promoted in both the public and private sectors.
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I agree with the approach to solving the corruption problem. If we follow the guidelines for solving the corruption problem, I think it will help reduce the corruption or it may help develop the principles until the corruption is gone.
However, in Thailand it is quite difficult due to corruption in all every places. Perhaps it may have been a custom of the country, without our realizing it was a corruption.
For guidline perharp to solve this sittuation such as;
Stakeholder meeting For I think it is going to be quite difficult. And may take a long time Because of the fear of losing interest and protection from powerful people.Prioritization of actions Decisions should be guided by both the impact on the health system and, in particular, to the risk group, and the existence of a possible solution to be successful.
Solving the corruption problem may have to start with ourselves first and then gradually develop into a cluster. I believe that one day we will be free from corruption.
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May I give my opinion on each step that public health professionals can do to fight corruption as provided in the article.
1. Seeking agreement: a proper whistleblowing policy needs to be set up in each health setting. Social media analysis would give clue to possible corruption for further investigation.
2. Prioritizing action: the more damaging corruptions to patients or the system should be prioritized with less consideration into who the beneficiary is.
3. Taking a holistic view: although it is challenging for researchers to indulge in health system corruption, by providing anti-corruption lessons in health-related graduate schools, this topic will become less intimidating in the research area.
4. Setting out what research community can offer: Including all disciplines related to corruption study seems to be impossible in my opinion. -
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Corruption is not often seen as a big issue in health-related fields though it brings a huge impact on the various level of the health sector. The editorial on corruption in health systems is a very good academic work that enlightens medical personnel to be aware of the reasons behind corruption and possible answers to address the corruption. Here’re my views on the four recommended points described in the editorial.
Convening key stakeholders to seek agreement on corruption: In almost every sector especially in the health setting, when a change is needed, it’s always a good idea to engage the key stakeholders to play a big part in the change. Anyway, it would be a challenging task to have a mutual agreement upon the scale and nature of corruption. Furthermore, in some cases, the key stakeholders themselves might be a part of the corruption whereas in some cases they could need legal and technical support if they act as whistleblowers.
Prioritizing the action: the extent of the solution to each problem in a corrupted health setting would surely vary. Some may need immediate attention, on the other hand, some may need to wait for a certain time. Anyway, there may be actions that require to be done in parallel for the synergistic effect. The team has to weigh the steps of the actions. Then the actions should also be closely monitored and evaluated, and their outcomes should be reported to the key stakeholders to adjust the prioritization.
Taking a holistic view: There’ll be no doubt that the process of corruption in the health setting would surely be interconnected to one another. So, when tackling corruption, the team should take a holistic view of this interactive nature of the corruption. This, in turn, needs to have a multi-disciplinary approach to the problem. Only comprehensive treatment will cure the health system sick with corruption.
Research: To me, I think every action to tackle corruption in a health setting needs to be based upon the informed decision which comes from the academic literature. The research body needs to support the team with its findings and results. And the role of big data in this technology era would surely be supportive of making informed decisions that help address corruption. -
After reading the article, it is quite clear that there is no standardized procedure or term to define corruption. In my opinion, there should be clear definition and code of conduct in organization and teams in every country. Firstly, we should have zero tolerance to corruption policy with crystal clear definition for corruption.
Secondly, punishment/action for corruption should be done. Law and legislation for taking action to corruption should be strongly encouraged so that there will be reduced corruption practices.
Thirdly, research in multi-disciplinary approach is vital starting from individual to country level. As mentioned in the article, there is few articles published related to corruption especially in health sector researches. Policy makers should consider to invest in such kind of research as it can save many beneficiaries and save budget for citizens.
The last but not the least, morality of each and every person is crucial to fight against corruption. Stories for children and trainings and guidelines for adult people should be repeatedly introduced to improve morality of each and everyone in the community.
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