ABSTRACT
Structural Adjustment Programmes (SAPs) of the IMF (IMF) and World Bank (WB) were implemented as part of aid conditionality in Africa and Latin America since the 1980s. There is a wide range of literature critical of SAPs. Several debates have focused on whether the failure of SAPs was a result of the inherent weaknesses of the IMF/ WB sponsored structural adjustment or whether it was caused by structural failures of policy implementation within the African continent. The author uses the Zimbabwean case to analyze the impact of SAPs on social service sectors, particularly the public health sector. This paper provides a case where the Zimbabwean health sector demonstrated significant progress in public health delivery, and showed prospects of further improvements before the implementation of structural adjustment between 1990 and 2000. In this thesis I show that cost recovery systems and reduced public expenditure on health led to rising costs of health services and increased inequalities in health service provision. It also resulted in the abandonment of critical public health programmes and consequently contributed to poor funding for health infrastructure, maintenance, drugs and equipments. Furthermore, retrenchments in the public health sector robbed it of critical and well qualified staff and exacerbated brain drain. SAPs were implemented amid public protests and demonstrations by the general public and organized interest groups. This is not only because they brought negative impacts on livelihoods but also because there were little consultations between the government and civil society prior to their implementation. This paper also illustrates that, to a larger extend SAPs increased women’s care burden and worsened their health situation. Household food consumption and family health needs are responsibilities bestowed upon women in Zimbabwe’s patriarchal society. Therefore, user fees and reduction of public health expenditure increased pressure on women to take care of the sick who could not afford medical fees. Furthermore, rising costs of maternal health, reduction of funds for preventive programmes and declines in public health staff had negative economic, psychological and health impacts on women.
Inhaltsverzeichnis (Table of Contents)
- I. INTRODUCTION
- II. LITERATURE REVIEW
- III. BACKGROUND SITUATION
- A. Demography
- B. Politics
- C. Economics
- IV. PRE-SAPS SITUATION OF HEALTH DELIVERY SYSTEM
- A. Socialism and the situation of Public Health Delivery
- B. Health Policies Adopted during the Pre-SAPs Period
- C. The Free Health for All Policy
- V. INTRODUCTION OF SAPS AND RESULTANT IMPACT
- A. Introduction of SAPs and their Impact on Poverty
- B. Changes Instituted by SAPs and their Impact
- 1. Economic Liberalization- Free Market and Competition
- 2. Reducing Public Health Grant
- 3. Cost Recovery Systems
- 4. Reducing Public Sector Employees
- 5. Reaction of Population Towards Implementation of SAPs
- VI. THE GENDERED DIMENSIONS OF THE IMPACT OF SAPS ON ZIMBABWE'S PUBLIC HEALTH SECTOR
Zielsetzung und Themenschwerpunkte (Objectives and Key Themes)
This thesis aims to conduct a case study analyzing the impact of Structural Adjustment Programmes (SAPs) on Zimbabwe's public health sector. The study seeks to understand the changes implemented by SAPs, their consequences on the health system, and the resulting effects on the population, particularly considering gendered dimensions. * Impact of SAPs on Zimbabwe's public health system. * The pre-SAPs situation and health policies in Zimbabwe. * Economic liberalization and its effects on healthcare access and affordability. * Gendered disparities arising from SAPs implementation in the healthcare sector. * The socio-economic consequences of SAPs on the health status of the Zimbabwean population.Zusammenfassung der Kapitel (Chapter Summaries)
I. INTRODUCTION: This introductory chapter sets the stage for the thesis by outlining the research problem: the impact of Structural Adjustment Programmes (SAPs) on Zimbabwe's public health sector. It provides a brief overview of the thesis's objectives and methodology, highlighting the significance of understanding the interplay between economic policies and public health outcomes in a developing country context like Zimbabwe. The chapter establishes the rationale for the study and positions it within existing literature on the topic, indicating the knowledge gap this thesis seeks to address. II. LITERATURE REVIEW: This chapter provides a comprehensive review of existing literature relevant to the study. It examines previous research on the impact of SAPs on health systems in developing countries, exploring diverse perspectives and methodologies used in similar studies. It establishes a theoretical framework for understanding the mechanisms through which SAPs might affect health outcomes, incorporating relevant theories from economics, public health, and development studies. The chapter also discusses existing literature on Zimbabwe's health sector, setting the context for the specific case study. III. BACKGROUND SITUATION: This chapter establishes the socio-political and economic background of Zimbabwe, providing essential context for understanding the impact of SAPs on the public health sector. It covers key demographic trends, political history, and economic policies preceding the implementation of SAPs. This section lays the groundwork for analyzing the pre-SAPs health system by presenting critical information on the country's context. The interaction between political stability, economic growth, and the health infrastructure's development will be discussed. IV. PRE-SAPS SITUATION OF HEALTH DELIVERY SYSTEM: This chapter focuses on the state of Zimbabwe's public health delivery system before the introduction of SAPs. It explores the health policies adopted during the pre-SAP period, particularly analyzing the impact of socialist policies on healthcare provision. The chapter delves into the "Free Health for All" policy, assessing its successes and failures in providing equitable healthcare access to all citizens. By examining this pre-SAPs period, the chapter establishes a baseline for comparing and contrasting with the post-SAPs situation. V. INTRODUCTION OF SAPS AND RESULTANT IMPACT: This pivotal chapter analyzes the introduction of SAPs and their subsequent impact on various aspects of Zimbabwe's public health sector. The chapter explores the effects of economic liberalization, decreased public health grants, cost-recovery systems, and the reduction in public sector employees. It also examines the population's response to the implementation of these policies. The chapter meticulously details how specific SAP measures altered healthcare provision, access, and affordability. VI. THE GENDERED DIMENSIONS OF THE IMPACT OF SAPS ON ZIMBABWE'S PUBLIC HEALTH SECTOR: This chapter explores the differentiated impact of SAPs on men and women within Zimbabwe’s public health sector. It examines how gender inequalities were exacerbated or mitigated by the policies implemented, considering the role of gender in access to healthcare, health outcomes, and decision-making processes. The chapter investigates how existing gender norms and power dynamics interacted with SAPs to shape healthcare experiences and outcomes.Schlüsselwörter (Keywords)
Structural Adjustment Programmes (SAPs), Zimbabwe, Public Health, Healthcare Access, Economic Liberalization, Poverty, Gender, Health Policy, Cost Recovery, Health Outcomes, Developing Countries.
Frequently Asked Questions: Impact of Structural Adjustment Programmes (SAPs) on Zimbabwe's Public Health Sector
What is the main focus of this document?
This document provides a comprehensive preview of a thesis analyzing the impact of Structural Adjustment Programmes (SAPs) on Zimbabwe's public health sector. It includes a table of contents, objectives and key themes, chapter summaries, and keywords.
What are the key objectives of the thesis?
The thesis aims to conduct a case study analyzing the impact of SAPs on Zimbabwe's public health sector. It seeks to understand the changes implemented by SAPs, their consequences on the health system, and the resulting effects on the population, with a particular focus on gendered dimensions.
What topics are covered in the literature review?
The literature review examines previous research on the impact of SAPs on health systems in developing countries, exploring diverse perspectives and methodologies. It establishes a theoretical framework for understanding how SAPs affect health outcomes, drawing on theories from economics, public health, and development studies. It also discusses existing literature on Zimbabwe's health sector.
What is the background information provided on Zimbabwe?
The document provides essential socio-political and economic background information on Zimbabwe, including demographic trends, political history, and economic policies preceding the implementation of SAPs. This context is crucial for understanding the pre-SAPs health system.
What does the document say about the pre-SAPs health delivery system in Zimbabwe?
This section explores the state of Zimbabwe's public health delivery system before SAPs, analyzing the impact of socialist policies and the "Free Health for All" policy on healthcare provision and equitable access.
How does the document analyze the impact of SAPs on Zimbabwe's public health sector?
The document meticulously details the introduction of SAPs and their impact on various aspects of Zimbabwe's public health sector. This includes the effects of economic liberalization, reduced public health grants, cost-recovery systems, and the reduction in public sector employees, along with the population's response.
What is the significance of the chapter on gendered dimensions?
This chapter explores how SAPs differentially impacted men and women in Zimbabwe's public health sector, examining how gender inequalities were exacerbated or mitigated by the policies, considering gender's role in healthcare access, outcomes, and decision-making.
What are the key words associated with this thesis?
Key words include: Structural Adjustment Programmes (SAPs), Zimbabwe, Public Health, Healthcare Access, Economic Liberalization, Poverty, Gender, Health Policy, Cost Recovery, Health Outcomes, Developing Countries.
What is the overall structure of the thesis?
The thesis is structured into six chapters: Introduction, Literature Review, Background Situation, Pre-SAPs Situation of Health Delivery System, Introduction of SAPs and Resultant Impact, and The Gendered Dimensions of the Impact of SAPs on Zimbabwe's Public Health Sector.
Where can I find more detailed information?
This document is a preview; the complete thesis contains more in-depth analysis of each topic mentioned here.
- Quote paper
- Tsitsi Muvunzi (Author), 2011, The Impact of Structural Adjustment Programmes on Zimbabwe’s Public Health Sector, Munich, GRIN Verlag, https://www.grin.com/document/213313