The Corruption Game: Health Systems, International Agencies, and the State in South Asia
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Abstract
Drawing on ethnographic material collected in Pakistan, India, and Nepal, this
article analyzes patterns of corruption in vaccination programs in South Asia. Corrupt
practices—which required substantial work—were deeply shaped by both the
money and systems of accountability of the global health system. Bilateral and multilateral
donors provided substantial funding for immunization programs across
South Asia. International agencies and governments instituted systems of accountability,
including documentation requirements and a parallel UN bureaucracy in
problematic districts, to try to ensure that health workers did what they wanted.
Some immunization program staff skillfully bent these systems of accountability to
their own ends, diverting vaccination funding into their own pockets. Corruption
operates not in opposition to the official rules, but in spaces opened up by them.
These practices sometimes transform Weber’s rational bureaucracy into a sophisticated
game with many players, whose aims are more complex than the stated goals
of the bureaucracy.
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Citation
Svea Closser. (2020-5-18). "The Corruption Game: Health Systems, International Agencies, and the State in South Asia." Medical Anthropology Quarterly. 34 (2). 10.1111/maq.12549.