ACC recommends 20 reforms for healthcare, Aasandha
One of the most important recommendations is the need to reduce state expenditure to ensure the Aasandha scheme remains sustainable.
The Anti-Corruption Commission (ACC) of Maldives on Thursday released a detailed report outlining the corruption threats within the country’s health welfare system, specifically focusing on the Aasandha scheme.
The report, which was based on data collected from 2011 to 2023 and studied from 2022 to 2023, highlighted significant issues in the system and provided 20 recommendations aimed at improving transparency, reducing corruption, and ensuring the sustainability of the Aasandha scheme.
At a special ceremony hosted by the ACC, Housing Minister Dr Ali Haidhar launched the report, which is now available on the ACC website. The study was undertaken with the primary objective of identifying corruption risks in the Maldives’ health welfare system and proposing reforms that could help reduce corruption and improve service delivery.
The ACC's investigation revealed six major problems within the Aasandha scheme and broader health welfare system:
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Lack of a robust legal framework to ensure the integrity of service delivery.
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Absence of a claim process validation system, meaning there is no mechanism to ensure payments are made for services actually provided.
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Lack of transparency in the registration of new services and drugs at healthcare providers.
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Facilitation of corruption in the payment of bills to service providers under the Aasandha scheme.
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No accountability in managing and monitoring the system.
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Inequality in assistance payments under the National Social Protection Agency (NSPA).
In response to these findings, the ACC outlined 20 key recommendations aimed at addressing these weaknesses and strengthening the system. One of the most important recommendations is the need to reduce state expenditure to ensure the Aasandha scheme remains sustainable.
The commission emphasised the development and implementation of a long-term plan to reduce costs. It also called for special studies and systemic changes to help restore public confidence in the scheme.
To bolster the integrity of the system, the ACC recommended strengthening the legal framework that governs Aasandha. Existing regulations should be reviewed, and comprehensive rules formulated. Specifically, the commission highlighted the need for clinical and practice guidelines related to drugs, services, and medical professionals.
The ACC also urged the establishment of clear rules for drug pricing and the development of a national prescribing standard.
Other recommendations provided by the ACC include:
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Establishing a circular referral system for doctor visits in Maldives to regulate and streamline healthcare service access.
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Formulating a regulation to manage the dual practice of government doctors working in both public and private hospitals.
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Introducing a national pricing scheme for health services and medicines, including setting maximum retail prices and standardising services offered under the Aasandha scheme.
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Implementing a "claim process validation" system, which would ensure payments are made only after services have been received.
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Increasing transparency in service and drug registration by making the process publicly visible and introducing a system for receiving and responding to complaints related to registration.
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Amending rules and regulations to adjust penalties for late payments in a way that considers the interests of the state, service providers, and medical suppliers.
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Appointing a body to monitor the entire system and conduct financial impact assessments, strengthening accountability and ensuring the proper functioning of the health welfare system.
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Improving the NSPA assistance process by setting thresholds for expenditure based on the type of medical treatment and the applicant’s circumstances, as well as making the progress of assistance requests visible to applicants.
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Introducing and implementing an auditing mechanism to monitor the quality of facilities empaneled under the Aasandha scheme and establish a national health database for more efficient management.
The ACC’s recommendations are a response to the pressing need for reform in the Maldives’ health welfare system.
The commission’s report has highlighted significant gaps in transparency, accountability, and cost management, all of which must be addressed to prevent corruption and ensure that the Aasandha scheme can continue providing essential health services to the Maldivian people.
