Does bribery increase maternal mortality? Evidence from 135 Sub-Saharan African regions

PLOS Glob Public Health. 2023 Dec 4;3(12):e0000847. doi: 10.1371/journal.pgph.0000847. eCollection 2023.

Abstract

About 295,000 women died globally during and following pregnancy and childbirth in 2017. Two-thirds of these deaths occurred in Sub-Saharan Africa. By linking individual and regional data from 135 regions in 17 Sub-Saharan African countries over the period 2002-2018 this study explores how bribery affects maternal mortality in Sub-Saharan Africa. Our results show that the percentage of people who had first-hand experience in bribery is significantly and positively associated with pregnancy related deaths. We find that a 10 p.p. increase in the prevalence of bribery is associated with up to 41 [95% CI: 10-73] additional deaths for every 1,000 pregnancy-related deaths. However, the healthcare system quality appears to be an important moderator. To reduce maternal mortality, policy makers should not only increase investments in healthcare, they need also to implement measures to combat corruption.

Grants and funding

This study represents independent research funded by the European Research Council (ERC) under the European Union’s Horizon 2020 research and innovation programme, grant agreement n° 694145- IFAMID (AA, EP, VT) and by the Norwegian Research Council: 288638 (AK). Both funders are gratefully acknowledged. The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.