CORRUPTION AND HEALTH 7: Epidemic, endemic, and pandemic corruption in Guatemala's Healthcare System due to the absence of effective health governance

Abstract

Introduction: Government corruption—the abuse of power for improper personal gain—represents one of the most harmful threats to the health, economy, and development of Guatemala.
Objective: To share intelligence—knowledge and evidence—with the newly elected government for the 2024–2027 period in order to restore stewardship of the health system, combat corrupt practices, and foster reflection on the needs and expectations of the population so as to avoid an anti-vote in the 2027 elections.
Method: A qualitative study was conducted using four methodologies: induction; literature review and selection of publications on health reforms and corruption and health; individual and group interviews with key informants; and the author’s executive experience in more than 20 countries over more than 30 years.
Results: Corruption in the health sector is akin to an infection or disease that spreads in epidemic, endemic, and pandemic forms across the public, private, and non-profit sectors at all levels. This corruption is attributed to the loss of the Ministry of Health’s capacity to exercise its fundamental function of health system stewardship; therefore, the concept is redefined, and six essential functions and six key actors are proposed.
Conclusions: Health stewardship is the cornerstone for preventing, detecting, and sanctioning corrupt practices and for achieving the three performance goals of a health system—improving health status, responding to legitimate expectations, and ensuring equity in the population’s financial contribution.