The impact of economic crises on health in Sudan 1978-1997 : a theoretical and empirical exploration

Though past studies have probed the social impact of economic crises and the adjustment policies designed to reverse them, a relative paucity of studies of the health impact persists. Moreover the diversity of the impact makes individual country case studies essential. Against this background this study undertook a comprehensive survey of the theoretical literature that frames the analysis of the interrelations between health and economic adjustment. Based on the literature survey and guided with the research objectives the study adopted an analytical framework that traces the impact of the economic adjustment variables from their macro level through the intermediate level down to the micro level where decisions affecting health conditions are taken. Throughout the analysis a combined methodology that uses the before and after and the theoretical approaches has been adopted. This research design proved its efficacy especially within the context of data constraints . The chosen analytical framework and analytic strategy described above were applied to Sudanese data covering the reference study period 1978-1997 or a sub-period(s) within this period. Although each data set taken separately may not meet the optimally desired data requirements, the analyses showed that the conclusions reached on the basis of different data sets corroborate each other. Also the analytical framework adopted enabled the theoretical assessment of the adequacy of the statistfos by checking empirical consistency of findings with theoretical a priori expectations. This ability to assess the quality of the data is of importance m an area where the availability of data is an admitted problem. The study investigated the impact on the macroeconomic health related inputs, then moved to consider the impact on intermediate health inputs, and finally the effects on health status were explored. The available data indicated that the changes in all these variables were consistent and many of the odd changes in single variables could in most cases be explained by subscribing to theoretical reasoning and/or more thorough investigation of data. Therefore it has been concluded that there was deterioration in the general health levels of the
population, which are consistent with the deterioration in the availability of health-related inputs at the macro and meso levels. However the available evidence suggests an association between the deterioration in health levels and economic adjustment variables, but may not be sufficient to suggest causality. Thus despite the consistency of this finding with the chosen analytical
framework the utility of further studies in this virgin field of applied economic research should not be underestimated.