The World Bank, Development, and Health



This chapter introduces the central puzzle guiding the book: how is it that the World Bank, viewed as a neoliberal hegemon, was unable to effect sweeping market-oriented reforms in health in Latin America, a region mired by economic crisis and recession and needful of external funding? I set up the theoretical framework that guides the book, drawing from the literatures on global governance, neoliberalism and the Washington and possible post-Washington consensus, and health systems research. I introduce the concepts of state autonomy and capacity in health as well as the paradigmatic goals (equity and efficiency) and policy instruments (in particular, I examine (1) decentralization and deconcentration, (2) performance-based financing, (3) separation of functions across and within institutions, (4) targeting, (5) private sector involvement, and (6) primary health care model) framework which guides my analysis. I discuss my research design and provide historical background on the health sectors of Argentina, Costa Rica, and Peru’s in order to contextualize these countries’ different responses and episodes of health sector reform between 1980 and 2005, setting the stage for the developments discussed in the book.


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Authors and Affiliations

  1. 1.Department of SociologyUniversity of WyomingLaramieUSA

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