Austerity in Africa: Audit cultures and the weakening of public sector health systems

Publication Date:

01 Mar 2019

Citation:

Pfeiffer J. (2019). Austerity in Africa: Audit cultures and the weakening of public sector health systems. Focaal. 2019(83), 51-61. doi: 10.3167/fcl.2019.830105

 

Abstract

Austerity across Africa has been operationalized through World Bank and IMF structural adjustment programs since the 1980s, later rebranded euphemistically as poverty reduction strategies in the late 1990s. Austerity’s constraints on public spending led donors to a “civil society” focus in which NGOs would fill gaps in basic social services created by public sector contraction. One consequence was large-scale redirection of growing foreign aid flows away from public services to international NGOs. Austerity in Africa coincides with the emergence of what some anthropologists call “audit cultures” among donors. Extraordinary data collection infrastructures are demanded from recipient organizations in the name of transparency. However, the Mozambique experience described here reveals that these intensive audit cultures serve to obscure the destructive effects of NGO proliferation on public health systems.

 

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Our mission is to promote policies and support programs that strengthen government primary health care and foster social, economic, and health equity for all. Our vision is a just world that promotes health and well-being, including universal access to quality health care.

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Health Alliance International began in 1987 as a US-based international solidarity organization committed to supporting the public sector provision of health care for all.  Over 35 years, HAI conducted programs in 17 countries, with flagship programs in Mozambique, Côte d'Ivoire, and Timor-Leste.

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