International Development, Community, and Environment

Title

The Anti-Politics of Health Reform: Household Power Relations and Child Health in Rural Senegal

Document Type

Article

Abstract

This article employs ethnographic evidence from rural Senegal to explore two dimensions of health sector reform. First, it makes the case that health reforms intersect with and exacerbate existing social, political, and economic inequalities. Current equity analysis draws attention to the ways that liberal and utilitarian frameworks for health reform fail to achieve distributive justice. The author's data suggest that horizontal power relations within households and small communities are equally important for understanding health disparities and the effects of health reform. Second, the article explores how liberal discourses of health reform, particularly calls for 'state-citizen partnerships' and 'responsiblization', promote depoliticised understandings of health. Discourses associated with health reform paradoxically highlight individual responsibility for health while masking the ways that individual health practice is constrained by structural inequalities. © 2009 Taylor & Francis.

Publication Title

Anthropology and Medicine

Publication Date

4-1-2009

Volume

16

Issue

1

First Page

61

Last Page

71

ISSN

1364-8470

DOI

10.1080/13648470802426243

Keywords

health reform, neoliberalism, Senegal

Disciplines

Social and Behavioral Sciences | Sociology

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