On 13 and 14 June 2026, the Association ESE conducted a Training of Trainers for healthcare workers on the topic “A Stronger System for Fairer Protection: Reducing Corruption in Healthcare.” The training brought together healthcare workers from different levels of healthcare and different regions of North Macedonia, with the aim of strengthening their knowledge and skills to recognize, prevent, and appropriately address corruption in the healthcare system.

During the two-day training, several interconnected topics were covered: medical deontology and ethical conduct, the link between medical ethics and corruption in healthcare, the gender dimensions of corruption, inequality and sextortion, as well as mechanisms for reporting, protection, and institutional accountability. In addition, ESE presented the findings of the research “Corruption from Within and from the Outside – Healthcare Workers’ Perceptions of Corruption in Services, Employment, Promotions, and Public Procurement,” opening space for discussion on the real challenges faced by healthcare workers and patients.

A particularly important part of the training consisted of practical scenarios, case studies, and discussions, through which participants had the opportunity to connect the knowledge gained with concrete situations from the healthcare system. Participants actively engaged in the discussions, shared experiences, asked questions, and discussed possible ways to recognize and report different forms of corruption, including situations related to conflicts of interest, the use of personal connections, unequal access to services, and gender-based forms of abuse of power.

The analysis of the pre-test and post-test showed that healthcare workers improved their knowledge after completing the training. The greatest improvement was observed in recognizing gender-based forms of corruption, particularly sextortion, as well as in topics related to autonomy and informed consent, equal treatment of patients, normalized corruption, and the gender aspects of corruption in healthcare. These results show that the training contributed to strengthening knowledge on ethical and professional conduct, recognizing corruption risks, and using reporting and protection mechanisms.

The training evaluation showed a high level of satisfaction among participants. Participants particularly positively assessed the relevance of the content, the clear structure of the topics, the expertise of the trainers, the practical examples, and the opportunity for open discussion. Healthcare workers identified the topics related to reporting corruption, institutional accountability, legal mechanisms, practical scenarios, the gender dimensions of corruption, and ToT skills as the most useful parts of the training.

Within the training, initial preparations were also made for the implementation of regional trainings for healthcare workers. Participants worked on preparing presentation plans and content for regional trainings, and then presented the prepared plans before the group. In this way, the training was not focused solely on acquiring knowledge, but also on the practical preparation of healthcare workers to take on the role of trainers in their own communities.

Participants assessed that they will be able to practically apply the knowledge gained in their work and that the Training of Trainers will enable them to properly conduct regional trainings for other healthcare workers. This creates a foundation for the wider transfer of knowledge, strengthening professional accountability, and building a more informed and more resilient healthcare system in relation to corruption.

The training is implemented within the project “A Stronger System for Fairer Protection: Reducing Corruption in Healthcare,” implemented by the Association ESE with the support of Expertise France through AFD – Agence Française de Développement.

This content is the sole responsibility of the Association ESE and the partner organizations and can in no way be considered to reflect the views of Expertise France and Agence Française de Développement.