Authors ' conclusions There is a paucity of evidence regarding how best to reduce corruption .
Promising interventions include improvements in the  detection and punishment of corruption  , especially efforts that are coordinated by an independent agency .
Other promising interventions include guidelines that prohibit doctors from accepting benefits from the pharmaceutical industry , internal control practice s in community health centres , and increased transparency and accountability for co-payments combined with reduced incentives for informal payments .
Key messages The review suggests that some strategies to fight corruption in the health sector can have an effect on corruption .
This study shows that these strategies may have led to fewer patients giving their doctors informal payments ( low certainty evidence ) . •
The study suggests that this may have changed doctors ' attitudes about the influence of pharmaceutical companies on their choice of medicines ( low certainty evidence ) . •
We do n't know what the effects of these strategies have on healthcare or people 's health , or if these strategies had any harmful effects .
Background Corruption is the abuse or complicity in abuse , of public or private position , power or authority to benefit oneself , a group , an organisation or others close to oneself ; where the benefits may be financial , material or non- material .
It is wide-spread in the health sector and represents a major problem .
Objectives Our primary objective was to systematic ally summarise empirical evidence of the effects of strategies to reduce corruption in the health sector .
Our secondary objective was to describe the range of strategies that have been tried and to guide future evaluations of promising strategies for which there is insufficient evidence .
The extent to which increased transparency alone reduces corruption is uncertain .
Interventions to reduce corruption in the health sector What is the aim of this review ?
The aim of this Cochrane review is to assess the effectiveness of strategies to reduce corruption in the health sector .
Corruption can occur in any area of the health sector , and happens when people abuse their own position to benefit themselves , their organisation , or other people close to them .
It can take many forms , including bribes , theft , or giving incorrect or inaccurate information deliberately .
It can take money away from healthcare , lead to poorer quality care and make access to healthcare unfair , and often affects poor people the hardest .
A reanalysis of cluster randomized trials showed interrupted time-series studies were valuable in health system evaluation.
OBJECTIVES There is often substantial uncertainty about the impacts of health system and policy interventions . Despite that , r and omized controlled trials ( RCTs ) are uncommon in this field , partly because experiments can be difficult to carry out . An alternative method for impact evaluation is the interrupted time-series ( ITS ) design . Little is known , however , about how results from the two methods compare . Our aim was to explore whether ITS studies yield results that differ from those of r and omized trials . STUDY DESIGN AND SETTING We conducted single-arm ITS analyses ( segmented regression ) based on data from the intervention arm of cluster r and omized trials ( C- RCTs ) , that is , discarding control arm data . Secondarily , we included the control group data in the analyses , by subtracting control group data points from intervention group data points , thereby constructing a time series representing the difference between the intervention and control groups . We compared the results from the single-arm and controlled ITS analyses with results based on conventional aggregated analyses of trial data . RESULTS The findings were largely concordant , yielding effect estimates with overlapping 95 % confidence intervals ( CI ) across different analytical methods . However , our analyses revealed the importance of a concurrent control group and of taking baseline and follow-up trends into account in the analysis of C- RCTs . CONCLUSION The ITS design is valuable for evaluation of health systems interventions , both when RCTs are not feasible and in the analysis and interpretation of data from C- RCTs
Authors ' conclusions There is a paucity of evidence regarding how best to reduce corruption .
Promising interventions include improvements in the  detection and punishment of corruption  , especially efforts that are coordinated by an independent agency .
Other promising interventions include guidelines that prohibit doctors from accepting benefits from the pharmaceutical industry , internal control practice s in community health centres , and increased transparency and accountability for co-payments combined with reduced incentives for informal payments .
Key messages The review suggests that some strategies to fight corruption in the health sector can have an effect on corruption .
This study shows that these strategies may have led to fewer patients giving their doctors informal payments ( low certainty evidence ) . •
The study suggests that this may have changed doctors ' attitudes about the influence of pharmaceutical companies on their choice of medicines ( low certainty evidence ) . •
We do n't know what the effects of these strategies have on healthcare or people 's health , or if these strategies had any harmful effects .
Background Corruption is the abuse or complicity in abuse , of public or private position , power or authority to benefit oneself , a group , an organisation or others close to oneself ; where the benefits may be financial , material or non- material .
It is wide-spread in the health sector and represents a major problem .
Objectives Our primary objective was to systematic ally summarise empirical evidence of the effects of strategies to reduce corruption in the health sector .
Our secondary objective was to describe the range of strategies that have been tried and to guide future evaluations of promising strategies for which there is insufficient evidence .
The extent to which increased transparency alone reduces corruption is uncertain .
Interventions to reduce corruption in the health sector What is the aim of this review ?
The aim of this Cochrane review is to assess the effectiveness of strategies to reduce corruption in the health sector .
Corruption can occur in any area of the health sector , and happens when people abuse their own position to benefit themselves , their organisation , or other people close to them .
It can take many forms , including bribes , theft , or giving incorrect or inaccurate information deliberately .
It can take money away from healthcare , lead to poorer quality care and make access to healthcare unfair , and often affects poor people the hardest .