Privatizing Health Services in Africa

Privatizing Health Services in Africa analyzes the disappearance of public health in the form of state services in Africa, and the growth of a private market in health care that will serve primarily an urban elite. Meredeth Turshen considers the implications of introducing private insurance in countries with growing unemployment, a shrinking formal job sector, and a lack of social security programs or other safety nets. She debates the pros and cons of shifting the delivery of health services to the nongovernmental sector in the context of new concepts of the role of the state. Many of the schemes to privatize the purchase and sale of pharmaceuticals reverse decades of United Nations work challenging the power of the multinational drug industry. Turshen weighs these policy changes in light of the World Bank’s eclipse of the World Health Organization as the premier UN health policy agency. Until now, no book has disputed the World Bank’s plans to privatize health care in Africa. This is the first book-length analysis of policy changes in light of monetarism and globalization.

Throughout the book, Turshen examines the implications of privatization for gender equity. She also provides a case study of Zimbabwe and comparative material from Malawi, Mozambique, and Zambia. Her study makes a contribution to current debates on the impact of structural adjustment policies on health and the design of health services in the Third World.