On February 9, the Yuksalish movement presented the results of two studies conducted as part of the "Anticorruption Laboratory" project implemented in cooperation with the Anti-Corruption Agency and the international non-governmental organization "Regional Dialogue" (Slovenia).

One of the studies assessed the factors of integrity and corruption risks in student grading in higher education, and the other explored the factors of integrity and corruption risks in obstetrics.

A study “Integrity risks in assessing student knowledge in higher education”

The study covered 16 higher education institutions in 14 cities of the republic, which tried to determine the risks of corruption and their factors in assessing students' academic performance. The research methodology included the collection of qualitative and quantitative data through social surveys and interviews. Data collection covered various groups of respondents - representatives of the Ministry of Higher Education, Science and Innovations, rectors, vice-rectors, deans, heads of the educational departments, compliance-control and educational quality control departments, faculty, students, representatives of non-governmental non-profit organizations, a total of nearly 200 people.

The results of the analysis of the legal framework and public surveys showed that the existing information systems in the field are not perfectly developed, the awareness of anti-corruption measures is not complete, some procedures in the system have lost their effectiveness, and there are corruption risk factors in the field.

Regardless of the form of education, the academic performance of students in Uzbekistan is graded through continuous, mid-term and final control exams based on the evaluation criteria set by the Ministry.

One of the steps aimed at reducing the risk of corruption is that final examination processes are conducted by pedagogues who do not teach specific students. However, some shortcomings remain in the process of grading student knowledge.

Including:

- Information on students, entered by the teacher in the HEMIS information system (started to be used in HEIs of Uzbekistan in 2020) is open to the dean's office and students. Therefore, there is a possibility that a third party can see the information in the system and make changes to it. Also, the legal framework of this system has not been approved, its tasks have not been clearly defined;

- Both in the pedagogical team and among students, there is a belief that grades are not determined only based on knowledge, talent/ability, and manipulation of grades does not directly harm anyone;

- Students are interested in a higher score to claim for the raised scholarship, causing corrupt behavior when passing mid-term exams;

- Due to the fact that the credit-module system has not been fully implemented in higher education and there are no legal documents regulating this activity, each HEI organizes it based on its capabilities and powers;

- The lack of information base for checking independent work of students for plagiarism in most HEIs and in the republic as a whole causes Internet plagiarism. Plagiarism has become systematic and normal among students and teachers. A plagiarism checking platform has been created, it works on a commercial basis, so it is not affordable for all universities. It is also only valid for PhD students (review of articles and research papers), content in Russian and English is practically not checked for plagiarism. This also creates a risk of bias towards the assessment of student knowledge.

74.4% of the respondents who took part in the survey believe that the process of student grading is influenced. According to the respondents, the most common corruption risks are:

 Students put pressure on the teacher to change the grade (27.88%)

 Students offer gifts and rewards to teachers in order to get higher grades (16.03%)

 The administration of higher education institutions has the right to access the personal office of teachers in the HEMIS system and can change grades (10.00%)

 Nonattendance and absence of students at classes (9.45%)

 Students provide false medical certificates (8.33%).

27.8% of student-respondents admitted the possibility to change the grade by giving a gift (38.9%), providing service to the university (16.7%), giving money (5.6%).

At the same time, 72.2% of the interviewed teachers stated that they would not change the assigned grade for the informal payment.

Also, 19.3% of the respondents are not fully aware of anti-corruption measures and there is no mechanism for reporting corrupt behavior in educational institutions. 22.8% say that the salaries of teachers are low and it is one of the risk factors of corruption.

A study on "Integrity and Corruption Risks in Obstetrics Provision"

21 maternity hospitals in 7 regions of Uzbekstan (Tashkent, Syrdarya, Fergana, Kashkadarya, Navoi regions, Tashkent city and the Republic of Karakalpakstan) were included in the research. As part of the study, social surveys and interviews were organized. Various groups of respondents - representatives of the Ministry of Health, chief doctors of maternity hospitals, obstetricians-gynecologists, neonatologists, anesthesiologists-reanimatologists, therapists, obstetricians and nurses, women in childbirth and their relatives, about 400 people in total were involved.

It is worth mentioning that certain results have been achieved in the framework of the implementation of measures to reform the health care system in our republic regarding the formation of a modern system of providing medical care to the population. A number of national programs aimed at strengthening the reproductive health of the population, protecting motherhood and childhood have been implemented. In order to prevent the birth of children with hereditary and congenital diseases, national and regional screening centers were established.

The Concept of Development of the Healthcare System of the Republic of Uzbekistan in 2019-2025 was approved. The reforms envisaged in the concept include the transition to a modern financing system, which includes mandatory health insurance, payment for medical services per “treated case” linked to the real cost of health care, and many other steps that will have a major impact on preventing corruption. Although some work on the implementation of the concept, including testing of health insurance in some regions, has begun, its results have not been sufficiently documented and some measures (e.g. Code of Ethics for Medical Professionals) have not been properly implemented.

Today, there are 14 independent and 46 perinatal centers organized as part of maternity hospitals in the republic. Women suffering from a range of serious complications or conditions that are life-threatening or not covered by existing treatment standards or protocols, as well as infants born prematurely or with serious illness, are referred to perinatal centers.

In this study of the "Anticorruption Laboratory", an attempt was made to determine the risk factors of corruption in the provision of obstetric care (with special emphasis on the process of childbirth).

Over the years, there has been some consensus that informal payments for obstetric services are systemic. For example, pregnant women are entitled to midwifery services during childbirth, but the informal payment of 'money', literally, has become mandatory or customary and is widely accepted among the population.

In the studies, it was found that although the medicines recommended by some doctors are available in the hospital warehouse, they are encouraged to buy the medicines (analogs or those produced by a certain pharmaceutical company). The fact that medical institutions can operate private pharmacies also creates a potential conflict of interest, where the institutions have a vested interest in patients getting their drugs from their pharmacies.

The results of such research were presented to key participants in the process with recommendations for reducing the identified risks.

At the event, international experts on anti-corruption strategies and corruption risk assessment methodology, local experts, representatives of the Ministry of Health, Ministry of Higher Education, Science and Innovations, the Committee on Information and Openness of Public Agencies of the Senate of Oliy Majlis, NGOs, researchers, representatives of healthcare and higher education sectors spoke with views and proposals.

The final reports on anti-corruption are available in the "Publications" section of our website.

Press Service of the "Yuksalish" Movement