Addressing Bribery and Associated Social Norms in Healthcare: Results of a Behaviour Change Intervention in Tanzania

Claudia Baez Camargo*, Violette Gadenne, Veronica Mkoji, Dilhan Perera, Ruth Persian, Richard Sambaiga, Tobias Stark

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Practices of bribery in the delivery of public services become entrenched when they are driven by social norms of reciprocity. The resulting economies of favours, which are common across diverse geographical regions, are resilient to conventional anti-corruption measures because they are underpinned by strong social pressures. This article describes the results of a behaviour change intervention to address gift-giving as a form of bribery in a Tanzanian hospital. The intervention utilised environmental cues and a peer-led network approach to deliver messages aimed at disincentivising bribery. An exit survey of hospital users indicates a reduction of the ‘gift-offering propensity score’, capturing self-declared behaviour, from 23% before implementation of the intervention to 13% afterwards. We find similar changes in the enabling norms score. Semi-structured interviews with hospital users and health workers further support these findings. These results suggest that practices and norms around bribery might be changed through a multi-pronged approach that addresses both the ‘supply’ and ‘demand’ side of bribery.

Original languageEnglish
JournalEuropean Journal of Social Psychology
DOIs
Publication statusE-pub ahead of print - 9 Jan 2025

Bibliographical note

Publisher Copyright:
© 2025 The Author(s). European Journal of Social Psychology published by John Wiley & Sons Ltd.

Funding

The research underpinning this article was funded through an award from the Global Integrity Anti-Corruption Evidence Programme funded by the UK Foreign Commonwealth and Development Office (FCDO).

FundersFunder number
Global Integrity Anti-Corruption Evidence Programme - UK Foreign Commonwealth and Development Office (FCDO)

    Keywords

    • behaviour change
    • bribery
    • healthcare
    • intervention
    • social norms
    • Tanzania

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