Role of social norms and institutional characteristics in driving corruption (published in Governance, 2024)
Abstract:
Corruption in healthcare is widespread and consequential. Informal payments are a common form of petty corruption, especially in low- and middle-income countries. Using data from the Life in Transition Survey encompassing 33 countries across Europe and Central Asia, I analyze the prevalence and reasons behind informal payments made to public health providers. In addition to individual- and system-level factors often used in the literature, I also introduce a latent measure of social norms related to high levels of corruption. These are associated with a higher prevalence of making informal payments. This paper also bridges a gap between the corruption literature and health investigations of informal payments by introducing an analysis of why payments were made. I find that the association between health system characteristics and informal payments prevalence differs based on the reason for payment. This difference is further exacerbated by the existence of corruption-related social norms. The results of this analysis highlight the need to revisit existing anti-corruption policies. I test the robustness of the results by performing a Heckman correction analysis to control for missing data.
Media: BMJ
Framing effects when measuring corruption in healthcare – a survey experiment (forthcoming in Social Science and Medicine)
Abstract:
Informal payments in healthcare, a common form of petty corruption in Eastern European EU countries, raise significant measurement challenges. One in four patients reportedly engage in such transactions, which can involve cash or in-kind exchanges outside formal channels. Some view these payments as a corrupt practice, while others see them as a culturally ingrained, benign phenomenon reflecting the societal role of physicians. This ambiguity complicates measurement efforts at national and international levels.Our study delves into the influence of question framing on reporting informal payment experiences in healthcare, highlighting how survey question formulations can shape perceptions and reports of corruption. We utilize both secondary and primary data to examine framing effects in survey measures of petty corruption in public healthcare provision. We analyze Eurobarometer 397 survey data from 2014, focusing on 16,051 respondents who had interactions with the healthcare system. This analysis compares responses to questions framed neutrally (without mentioning words such as corruption or bribery) and those framed in a more loaded manner (asking respondents whether they have been asked or expected to make a bribe). Descriptive analyses identify associations between framing and self-reported informal payment experiences. To establish causal framing effects, we conducted an online survey experiment in Bulgaria and the UK, randomly assigning participants to respond to neutrally or loaded framed questions, paralleling those in the Eurobarometer. Additional analyses examine the differential effects of nationality and corruption-related social norms, assessed through Latent Class Analysis. Our findings indicate that question framing is significantly associated with differences in bribery reporting, with notable variations across countries. The Eurobarometer data reveal mixed framing effects on petty corruption reporting. In some countries, neutral framing correlates with higher self-reported corruption experiences, while in others, loaded framing elicits higher corruption prevalence. The experimental study confirms a significant, positive influence of neutral framing on self-reported informal payment experiences. Breaking down these differences by social norms, we find that respondents with a high-corruption social norm (beliefs about others like them making informal payments) are more likely to report informal payment experiences. However, this discrepancy between high- and low-corruption norm groups is significant only in the loaded treatment group.
Favoritism, social norms and responsiveness to bribery - a survey and lab experiment (working paper available upon request)
Abstract
The prevalence of bribery in public service provision, especially in low and middle-income countries, poses significant challenges in assessing its impact on favoritism and identifying its drivers and deterrents. This study seeks to understand the extent to which bribes lead to preferential treatment in situations where public resources are scarce and service demands are competitive. It also aims to explore the role of social norms in influencing such behaviors. The research employs a combination of laboratory and survey experiments with a representative sample from Bulgaria and the United Kingdom, totaling 800 participants. These experiments are designed to simulate real-world scenarios involving bribery and resource allocation. We use a novel allocation game mimicing a competition between two players who can bribe a third player responsible for allocating a limited number of hints. These hints substantially increase the likelihood of earning a monetary award. The study also tests the effect of various information treatments on the level of reciprocity as a result of bribes. These treatments include messages about ingroup and outgroup inequality and the possibility of rejecting bribes. The findings reveal that within and between the study countries, the primary driver of reciprocity in response to bribes is a corruption-related social norm—specifically, the belief that others within one's reference group also engage in favoring bribe-givers. The study finds that information treatments related to ingroup and outgroup inequality do not affect favoritism understood as actively rewarding the briber but do impact the likelihood of punishing them. This study contributes to a deeper understanding of how bribery affects the quality and equity of public service delivery. It highlights the significant role of social norms in driving bribery-related behaviors and suggests that efforts to counteract these norms could be key in reducing the impact of bribery. The results also imply that simply providing information about inequalities is not enough to change bribery behavior. These insights are crucial for policymakers and stakeholders aiming to address corruption in public service delivery, offering a basis for developing more effective anti-corruption strategies and policies.