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      Structural adjustment and public spending on health: evidence from IMF programs in low-income countries.

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          Abstract

          The relationship between health policy in low-income countries (LICs) and structural adjustment programs devised by the International Monetary Fund (IMF) has been the subject of intense controversy over past decades. While the influence of the IMF on health policy can operate through various pathways, one main link is via public spending on health. The IMF has claimed that its programs enhance government spending for health, and that a number of innovations have been introduced to enable borrowing countries to protect health spending from broader austerity measures. Critics have pointed to adverse effects of Fund programs on health spending or to systematic underfunding that does not allow LICs to address health needs. We examine the effects of Fund programs on government expenditures on health in low-income countries using data for the period 1985-2009. We find that Fund programs are associated with higher health expenditures only in Sub-Saharan African LICs, which historically spent less than any other region. This relationship turns negative in LICs in other regions. We outline the implications of these findings for health policy in a development context.

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          Author and article information

          Journal
          Soc Sci Med
          Social science & medicine (1982)
          Elsevier BV
          1873-5347
          0277-9536
          Feb 2015
          : 126
          Affiliations
          [1 ] Department of Sociology, University of Cambridge, UK. Electronic address: aek37@cam.ac.uk.
          [2 ] Department of Sociology, University of Cambridge, UK.
          Article
          S0277-9536(14)00835-1
          10.1016/j.socscimed.2014.12.027
          25576997

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