Rising Bribes: Accessing Public Health Services in Northern Cyprus during COVID-19

Abstract

Objective: This study investigates the impact of the COVID-19 pandemic on informal payments (bribes) in accessing public health services. It assesses whether the pandemic increased informal payments and whether vulnerable populations, namely women, migrants, and low-income individuals, were more susceptible to bribery.
 
 Methods: Data from pre-pandemic (2019) and pandemic (2021) Global Corruption Barometer surveys in Northern Cyprus were statistically analyzed to examine changes in informal payments and their associations with gender, income, and immigrant status.
 
 Results: The study revealed a significant surge in informal payments for accessing public health services during the COVID-19 pandemic. In 2019, 4.70% of respondents reported paying bribes, but in 2021, this figure spiked to 17.85%, with an odds ratio of 4.391 underscoring the magnitude of the increase. Notably, gender and socioeconomic disparities were evident. Women reported higher bribe rates (20.3%) compared to men (13.7%), migrants had substantially higher bribe rates (25.7%) than natives (15.7%), and individuals with lower incomes (25.6%) were more inclined to engage in bribery. Logistic regression estimation results showed that migrants had a 9.48% higher likelihood of bribery, low-income individuals had a 14.27% higher probability, and being female was associated with a 9.28% higher chance of engaging in bribery.
 
 Conclusion: This study highlights a troubling surge in bribery within the public health sector during the COVID-19 pandemic. Vulnerable populations, especially women, migrants, and low-income individuals, face increased risks. Urgent action is needed to combat corruption in healthcare during pandemics and ensure equitable access to healthcare services.
 
 Key Words
 COVID-19, bribes, public health, vulnerable groups, Cyprus