Perceptions of government and health-sector corruption and inappropriate professional conduct during the COVID-19 pandemic among workers in 13 Latin American countries: a multicountry cross-sectional study

Abstract

ABSTRACT Objectives To describe agreement with statements concerning perceived corruption in government and the health sector and perceived inappropriate acts by physicians and other health professionals during the COVID-19 pandemic, and to examine whether these perceptions differed according to occupational sector after accounting for country and participant characteristics among workers recruited from 13 Latin American countries. Study design Multicountry cross-sectional study. Methods We analyzed data from a non-probability online survey of 2,529 economically active workers recruited from 13 Latin American countries. Four Likert-type items assessed perceived corruption in government and the health sector and perceived inappropriate acts by physicians and other health professionals. Responses were summarized descriptively. Associations of occupational sector and country of residence with agreement were examined using modified Poisson regression models with robust variance, adjusted for age, sex, and educational attainment. Sensitivity analyses evaluated alternative outcome codings using ordinal and binary models. Results Agreement was more frequent for statements referring to corruption in government (57.9%) and the health sector (54.8%) than for statements referring to inappropriate acts by other health professionals (48.3%) or physicians (46.2%). After adjustment, occupational sector was not independently associated with agreement for any outcome (all global Wald tests p ≥ 0.52), whereas country of residence remained consistently associated across all models (all p < 0.001). These findings were consistent across multiple sensitivity analyses using alternative outcome codings and model specifications. Conclusions Among workers recruited from 13 Latin American countries, agreement was more frequent for statements explicitly referring to corruption in government and the health sector than for differently worded statements concerning inappropriate professional conduct. After accounting for country and participant characteristics, occupational differences were not independently associated with these perceptions. Because participants were recruited through non-probability sampling, the findings should be interpreted as descriptive of the recruited sample rather than as national estimates.