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Economic reform and health sector policy: lessons from structural adjustment programs
1Division of General Internal Medicine, West Los Angeles Veteran's Affairs Medical Center, CA, USA.
Social Science & Medicine (1982)
|September 1, 1996
Summary
Economic reforms, while aiming for growth, can negatively impact health, especially during critical development periods. Policymakers must adopt a multidisciplinary approach to mitigate these health risks.
Area of Science:
- Public Health
- Health Economics
- Development Studies
Background:
- Structural adjustment programs (SAPs) are economic policies often associated with short-term austerity for long-term growth.
- The impact of these economic policies on health outcomes, particularly during critical developmental stages, is a significant concern.
- Developing countries have extensive experience with SAPs, offering valuable insights into their health-related consequences.
Purpose of the Study:
- To analyze the complex and often unexpected effects of economic reforms on population health.
- To highlight the vulnerability of health care budgets and services under economic austerity.
- To inform health policymakers on the necessity of understanding and coordinating responses to economic policy impacts on health.
Main Methods:
- Review of developing country experiences with structural adjustment programs over approximately fifteen years.
- Analysis of the interactions between economic policies and health outcomes across multiple sectors.
- Examination of data to identify trends in preventable diseases and irreversible health deterioration.
Main Results:
- While overall health outcomes may not consistently decline, there is evidence of increased incidence of preventable diseases.
- Critical biological development periods, such as intrauterine and neural development, are particularly vulnerable to economic shocks.
- Reduced government spending can lead to deteriorating healthcare quality, nutritional challenges (especially in urban areas), and cessation of preventive programs.
Conclusions:
- Economic reforms necessitate a careful consideration of their intertemporal trade-offs on health.
- A multidisciplinary approach is crucial for health policymakers to understand and respond effectively to economic policy impacts.
- Improved data collection, alternative financing strategies, and strong political leadership are essential for safeguarding health during economic transitions.