Effects Of Structural Adjustment Programs Research Articles

Evolution in key indicators of maternal and child health across the wealth gradient in 41 sub-Saharan African countries, 1986–2019

BackgroundAggregate trends can be useful for summarizing large amounts of information, but this can obscure important distributional aspects. Some population subgroups can be worse off even as averages climb, for example. Distributional information can identify health inequalities, which is essential to understanding their drivers and possible remedies.MethodsUsing publicly available Demographic and Health Survey (DHS) data from 41 sub-Saharan African countries from 1986 to 2019, we analyzed changes in coverage for eight key maternal and child health indicators: first dose of measles vaccine (MCV1); Diphtheria-Pertussis-Tetanus (DPT) first dose (DPT1); DPT third dose (DPT3); care-seeking for diarrhea, acute respiratory infections (ARI), or fever; skilled birth attendance (SBA); and having four antenatal care (ANC) visits. To evaluate whether coverage diverged or converged over time across the wealth gradient, we computed several dispersion metrics including the coefficient of variation across wealth quintiles. Slopes and 5-year moving averages were computed to identify overall long-term trends.ResultsAverage coverage increased for all quintiles and indicators, although the range and the speed at which they increased varied widely. There were small changes in the wealth-related gap for SBA, ANC, and fever. The wealth-related gap of vaccination-related indicators (DPT1, DPT3, MCV1) decreased over time. Compared to 2017, the wealth-gap between richest and poorest quintiles in 1995 was 7 percentage points larger for ANC and 17 percentage points larger for measles vaccination.ConclusionsMaternal and child health indicators show progress, but the distributional effects show differential evolutions in inequalities. Several reasons may explain why countries had smaller wealth-related gap trends in vaccination-related indicators compared to others. In addition to service delivery differences, we hypothesize that the allocation of development assistance for health, the prioritization of vaccine-preventable diseases on the global agenda, and indirect effects of structural adjustment programs on health system-related indicators might have played a role.

A review of Rodwan Abouharb and David Cingranelli (2007) Human Rights and Structural Adjustment. Cambridge: Cambridge University Press

This is a comprehensive, well-presented, carefully-researched study on human rights effects of structural adjustment programs (SAPs) conducted by the World Bank and International Monetary Fund (IMF). The study stands out as one of the first large-N, systematic quantitative studies in book form that employs multivariate models to test an issue that has thus far been dominated by case studies. The issue of SAPs and human rights is not just academic, but it carries the most serious policy implications. In this age of global governance, vociferous anti-globalization groups are even calling for the abolishment of the International Financial Institutions (IFIs). This would be a valid enough proposal if the IFIs do more harm than good—the issue cannot be treated lightly, and it calls for the best available empirical evidence to inform policy (Milner 2005). Abouharb and Cingranelli, however, provide mixed results—SAPs increase violations of human rights, but they also increase the level of democracy in the long-run. How to evaluate these results depends of course on more intense scrutiny, but these results remind us to keep in mind the relative trade off between short-term pain and long-term gain. But what if the short-term pain, if it exists at all, is really small and fully worth it in the long-run? Liberal institutionalists believe that institutions, such as the IMF and World Bank, provide a global public good by promoting economic stability, economic monitoring and advice, and ‘low-cost’ finance for cash-strapped poor countries. Others argue that global economic stability comes at the expense of the poor, reflecting the nature of an unfair global economic system. The pessimists view SAPs as a systematic package of restructuring enforced on the poor states at a time of economic vulnerability. The SAPs apparently push neo-liberal policies on the signatories, forcing hapless governments to remove subsidies for the poor, cut government spending on services, devalue the currency, all of which impose hardship on the most vulnerable, often for the benefit of Wall Street and the rich elite. These poor

Student Entrepreneurship on Campus: A Survival Response or a Career Rehearsal? The Case of Egerton University Student Entrepreneurs

Kenya's university education faces a dilemma of increased demand for places against declining funding and increased graduate unemployment. The introduction of cost sharing, in an environment of increased poverty levels and inadequate educational loans and bursaries, has further aggravated matters. This article presents findings of a case study on 50 university students involved in small business ventures in an attempt to cope with their financial situations. The study sought to find out the characteristics of student entrepreneurs, reasons for entry into business and how they coped with studies while operating businesses. The study shows that most of the respondents came from humble backgrounds and ran business mainly for survival. These results have useful implications on the effects of Structural Adjustment Programmes in financing university education in Kenya and elsewhere in Africa.

The impact of the structural adjustment

This article examines the effects of structural adjustment programmes (SAPs) on Kenyan society. A series of economic and political reforms initiated by the World Bank and International Monetary Fund in Kenya since 1988 and especially after 1991 has transformed many aspects of the daily life of Kenyan people. These programmes have been linked to the high rate of income inequality, inflation, unemployment, retrenchments and so on, which have lowered the living standards, especially, those relating to the material resources in the family. Furthermore, the SAPs in Kenya have been linked to the increasing deviant and crime rates, ethnic hatred and discrimination and welfare problems, especially in the areas of education and health. African Journal of Social Work Vol.17(1) 2002: 81-98

Twinship in an Ekiti Yoruba Town

Attitudes toward twins in Ekiti Yoruba society have remained remarkably consistent over the past hundred years even while the outward signs of their treatment have radically changed. Twins were considered to be extraordinary beings in the past and continue to be considered so. However, the markers of this extraordinariness have shifted from open expressions reflected in publicly displayed twin shrines to private, personal shrines kept in individual rooms. This essay examines both the everyday ways by which the special status of twins is muted and the special circumstances in which this tendency is overridden. (Twinship, West Africa, Yoruba, Christianity, ritual) Yoruba twins have provoked considerable and diverse disciplinary discussion. The evocative rituals associated with twins have been remarked upon by anthropologists (Bascom 1969; Chappel 1974) as well as by sociologists (Fadipe 1970; Ojo 1966). The images carved in their memory, ere ibeji, have been discussed by art historians (Houlberg 1973; Pemberton 1988, 1989; Stoll 1980; Thompson 1971). Art historians and anthropologists alike have been interested in changes in practices associated with twins, from a period when twins were reviled and twin infanticide was common to a time when twins were revered as orisa (deities [Chappel 1974; Houlberg 1973; Lawal 1996; Thompson 1971]). The frequent birth of twins to Yoruba women has also provoked studies among medical researchers interested in understanding the genetic and environmental factors that may explain the four-fold difference in the rate of Yoruba twin births compared with European populations (Creinin and Keith 1989; Knox and Morley 1960; Nylander 1969). This article examines the literature on Yoruba twins as well as present-day perceptions and practices associated with them in one small Ekiti Yoruba town in southwestern Nigeria. It focuses on the changing cultural and economic factors that have affected ritual expressions of reverence for twins. Specifically, it considers various aspects of the secularization of belief, a sort of end of enchantment regarding twins and the accompanying diminution of ritual practices for them. This diminution is often attributed to widespread conversion to Christianity and Islam. For example, Houlberg (1973:20) observed that many Christians and Muslims no longer believe in the necessity of twin ritual and in the carving of ere ibeji, obeying the proscription against retaining any sculpture related to traditional Yoruba religious practices. Others, such as Moore (1986:301), have noted that economic constraints may limit the performance of traditional ritual, while still others have discussed the more recent effects of structural adjustment programs on art patronage and ritual performance specifically in Nigeria. The concern here is with the process whereby ritual practices performed for twins have come to be viewed as less compelling for their parents.(2) Specifically, I suggest that changing cosmological beliefs and everyday routines underlie this reassessment of twin rituals and that these changes need to be examined (Beidelman 1997). This particular process of change may be seen in the comments of some, but not all, of the younger parents of twins in the town. For them, Christian belief (and particularly Pentecostal worship) provides the ideological armature for the rejection of older practices and acceptance of new ones. But changes in the seemingly passive backdrop of the world ... defined by ceaseless and infinite activity (Beidelman 1997:247)--children getting ill and being taken to the hospital, children going to school and needing expensive books and uniforms, children eating imported foods--also contribute to this re-evaluation. By re-examining recent ritual practices and beliefs associated with Yoruba twins, this essay builds upon the earlier writing of Turner (1969), whose study of twins in Ndembu society has provided a valuable framework for subsequent analyses. …

Exploring alternatives for financing health care in Ethiopia: An introductory review article

Abstract Background: with increasing demand for services that is further propagated by high population growth and by people's response to newly emerging pathologies, nations in sub-Saharan African are faced with insurmountable problems in sustaining their health systems. The decline in international assistance and the effects of structural adjustment programs have made the situation even worse. Realizing the inadequacy of solely relying on the public sector, these countries are thus seeking alternative mechanisms for health care financing. Methods: this is a synthetic literature review to describe the situation of health care financing in Ethiopia. In addition, the newly adopted health care financing strategy was looked at from the perspective of policy analysis. Results: Health financing has been a major challenge for Ethiopia. The prospect of relying solely on public resources seems impractical ana the absolute total expenditure on health is quite a small fraction of the amount needed for purchasing a minimum essential health services package. This has led to the recent adoption of a health care financing strategy and initiation of implementing its specific components. The sin ?,gy encompasses alternatives that include: improving the efficiency of allocation and utilization of public resources, expanding the role of the private sector, and encouraging the development of risk sharing mechanisms. Conclusion: Looking at the adoption and implementation the health care financing strategy with a policy analysis approach is helpful for identifying its likely trajectory, and what needs to be done to avoid opposition, or to gain support. [Ethiop. J. Health Dev. 2001;15(3):153-163]

The Foreign Exchange Constraints to Economic Adjustment: The case of Iran

While a great deal of work has been devoted to the assessment of the effects of structural adjustment programmes, little is known about the relative importance of external financing and its contribution to the success of these adjustment programmes. This paper examines this question, using Iran's recent experience with an orthodox structural adjustment with its limited access to medium- and long-term external financing. Using the annual data for 1963-94, a three-gap model of growth is formulated and estimated in which economic growth is constrained by domestic saving, foreign exchange and public sector resource availability. The resulting foreign exchange-gap equation demonstrates a sharp trade-off between investment (capacity generation) and the capacity utilization rate. The model is simulated over the period 1995-99 under three growth path scenarios. The size of the foreign exchange gap under these growth path scenarios illustrates quite vividly the centrality of the foreign exchange constraint to the achievement of a modest growth rate in the medium-term.

The Economic Empowerment of Nigerian Women: Some Determinants of Access to Resources

This paper investigates some key determinants of the economic empowerment of Nigerian women.' In recent years, the development community has focused increasing attention on the empowerment of women as a result, among other things, of the debilitating effects of structural adjustment programs (SAPs) in Africa in the 1990s and the growing feminization of poverty. Bearing in mind the disproportionate share of responsibilities borne by women, as they seek to combine both productive and reproductive responsibilities within an inadequate resource base, women in Africa are among the poorest of all and are increasingly marginalized in Africa's current economic crisis and under structural adjustment policies. Kate Young reported that considerable evidence has accumulated throughout the 1980s of increasing maternal poverty as result of debt and SAPs and ... this has been accompanied by the feminization of poverty.2 While many reasons have been advanced for Africa's economic crisis, the general consensus in many quarters is that SAPs have rendered more visible the failure of orthodox top-down development paradigms.3 Consequently, the United Nations Economic Commission for Africa (UNECA) proposed the Africa Alternative Framework to Structural Adjustment (AAF-SAP) as a human-centered strategy of recovery and self-reliant development for the continent. The United Nations Economic Commission for Africa (UNECA) in 1989 recommended a bottom-up strategy of empowerment of community organizations, peoples' organizations, and women's groups in order to enhance their access to resources and to strengthen their participation in decision making at all levels.4 These views were adopted as the African Charter for Popular Participation in Development and Transformation at the Arusha Conference of Ministers of Planning and Finance in 1990 and were also endorsed by the heads of states of the Organization of Unity (OAU).

Topics for our times: from Cairo to Beijing-women's agenda for equality.

The Beijing Declaration and Platform for Action represent the work of millions of women over the years and months preceding the 1995 Fourth World Conference on Women. The ambitious scope of the Platform can be exposed by highlighting several key areas. For example the concept of womens rights as human rights was advanced and the responsibility to protect human rights activists was recognized. The reproductive and sexual health needs of women and girls received special attention and gender inequalities were deemed responsible for health care inequalities. Compromise action on inheritance policies led to language that insured women and girls an equal right to inheritance and succession (but not necessarily the right to inherit the same amount as sons). The Platform for Action further delineated and denounced acts of violence against women and urged all governments to ratify the Convention on the Rights of the Child. Economic issues considered included the fact that women constitute over 70% of the worlds poor. Thus the Platform recognized the need to provide low-income countries with assistance with multilateral debt and to mitigate the effects of structural adjustment programs as well as to include assessments of womens unpaid work in statistical analyses. Environmental protection was called for and governments were urged to maintain a gender perspective in all environmental policies and programs. The pressure of the women in the nongovernmental organizations (NGOs) led to a concrete commitment of action on these issues by many countries. The NGOs are becoming the driving force for the implementation of UN activities and with their rapidly increasing numbers wield a greater impact than did old alignments. With thousands of women attending workshops on how to use the Internet to maintain contact an unstoppable and unprecedented international womens movement toward empowerment and equality is developing.

The World Bank and ‘adjustment in Africa’

This article continues the debate on the effects of structural adjustment programmes in Africa as portrayed by the World Bank in Adjustment in Africa: Reforms, Results, and the Road Ahead (1994a). The World Bank's claim that ‘better policies pay off is found to be underspecified and misleading. Much of the divergence in growth rates between countries with different records of policy reform implementation results from the World Bank's peculiar classification and from the condition of the various economies prior to reform. It is concluded that the World Bank, rather than demonstrating the need for more adjustment, has revealed its failure to adopt an adequate long‐term strategy for Africa.

Do poverty programs alleviate poverty? The case of the Mexican National Solidarity Program.

In recent years, compensatory poverty programs have been adopted in several countries in response to the social and political effects of structural adjustment programs implemented by most Latin American and African countries. The authors analyze the Mexican National Solidarity Program "Pronasol," often cited as an exemplary social compensation program, by inquiring into its impact on poverty. The authors first investigate the relationship between structural adjustment and the process of impoverishment, in order to establish the dynamics and magnitude of poverty in Mexico. They find that the structural adjustment program has considerably increased poverty, mainly through a sustained wage decrease and job losses. The authors next discuss whether Pronasol complies with the requisites of a program that warrants a social minimum for the poor, and whether the resource allocation complies with objective criteria of the sociogeographic distribution of poverty. The data suggest that Pronasol cannot be considered to guarantee a social minimum for the poor, given the magnitude of poverty, the scarce resources allocated, the orientation of the subprograms, and the regional distribution of funds. Nor does it qualify as a social compensation program of any importance. Finally, an alternative interpretation of Pronasol is offered in the field of legitimation and political control.

Gendered impacts of fertilizer subsidy removal programs in Malawi and Cameroon

AbstractGladwin's** main contention is that women provide most of the agricultural labor in sub‐Saharan Africa and because much of this labor is oriented to food production for home consumption, the effects of structural adjustment programs on them and the children they work to feed are likely to be different than on men who produce crops for commercial and export production. Her specific hypothesis for Malawi is that the removal of the fertilizer subsidy affects women farmers more than men farmers because it reduces fertilizer use on local maize. As part of the structural adjustment program, a major purpose of removing the fertilizer subsidy is to reallocate resources from food production for domestic consumption to cash crop production for export. In Gladwin's analysis, men farmers produce hybrid maize and tobacco for export and women produce the subsistence food crop, local maize. Gladwin's main contention is probably correct. For the Malawi case, the presentation does not support the hypothesis because two of the major underlying assumptions are inappropriate and the evidence provided is inconclusive. This comment proceeds by discussing the two assumptions and corresponding evidence. The purpose of this comment is not to contradict the hypothesis, but to clarify the Malawi situation and to suggest that a different analytical approach is needed in that context.

Gendered impacts of fertilizer subsidy removal programs in Malawi and Cameroon

Gladwin's ∗∗ main contention is that women provide most of the agricultural labor in sub-Saharan Africa and because much of this labor is oriented to food production for home consumption, the effects of structural adjustment programs on them and the children they work to feed are likely to be different than on men who produce crops for commercial and export production. Her specific hypothesis for Malawi is that the removal of the fertilizer subsidy affects women farmers more than men farmers because it reduces fertilizer use on local maize. As part of the structural adjustment program, a major purpose of removing the fertilizer subsidy is to reallocate resources from food production for domestic consumption to cash crop production for export. In Gladwin's analysis, men farmers produce hybrid maize and tobacco for export and women produce the subsistence food crop, local maize. Gladwin's main contention is probably correct. For the Malawi case, the presentation does not support the hypothesis because two of the major underlying assumptions are inappropriate and the evidence provided is inconclusive. This comment proceeds by discussing the two assumptions and corresponding evidence. The purpose of this comment is not to contradict the hypothesis, but to clarify the Malawi situation and to suggest that a different analytical approach is needed in that context.

The Working Behavior of Young People in Rural Côte d'Ivoire

One of the major features of structural adjustment is an attempt to reallocate laborand hence output-through changes in relative prices. This article assesses how price changes affect the working patterns of young people in rural C6te d7voire. The analysis is based on a model of the labor supply of rural households and on the construction of composite price indexes. The data come from the C6te d'Ivoire Living Standards Survey for 1985 and 1986. The panel aspect of the data allows the work choice made in one year to depend on the individual's choice in the previous year. Results indicate that the price of agricultural output generally is a positive incentive on the decision to participate in the labor force. However, this result depends heavily on the employment and education of the individual in the previous period. Those not already working are less likely to respond to favorable movements in the prices of cash crops by entering the work force. This article reports on research on the determinants of working patterns among young people in rural C6te d'Ivoire. Because young people's decisions about working are closely related to decisions about schooling, the article also focuses on the relationship between work and school. The motivation for this study arises from an interest in the effects of structural adjustment programs on work incentives. Structural adjustment is expected to increase output by altering the incentives facing producers. The effect of improved incentives could, in principle, be measured by directly observing changes in output. The time lag between the change in incentives and the change in output can be substantial, however, especially when tree crops are involved, so that data over a long period may be

Import Dependency and Structural Adjustment in Sub-Saharan Africa

One of the effects of structural adjustment programs in Sub-Saharan Africa has been the reduction of imports in the face of scarce foreign exchange. This article takes the analysis of import demand beyond the traditional income and price determinants to account for factors likely to be important to Sub-Saharan African countries in the 1990s. First, the effect of demand on imports is reflected by the level of absorption rather than the less direct income variable. Second, because adjustment programs may cut government consumption and, through increases in interest rates, reduce investment, these components of absorption are also considered independently to assess their differential effect on imports. Third, import barriers are often set in dollar terms to limit the use of foreign exchange. Because reliable and complete data for import restrictions are not available, the ratio of exports to debt is included as an indicator of foreign exchange availability to reflect its effect on trade barriers and thus imports. The findings suggest that this more comprehensive assessment of import demand will be needed if the size and even direction of changes in import demand in response to policy reform is to be understood and anticipated.

The effects of structural adjustment programmes

Many developing countries are trying to improve their economic conditions by means of structural adjustment programmes. The following article points out the weaknesses of such programmes and draws conclusions about the support that should be given to economic reform in developing countries in the future.