The first wave of neoliberal reform that swept across Latin
America in the early 1990s focused on economic policies favoring
structural adjustment, such as currency devaluation, cuts in
state-supplied social services, and removal of protection for
domestic industry against global competition. This wave has been
the subject of widespread debate and criticism for its negative
impact on the most vulnerable strata of society. But the second
wave of the mid-1990s, which saw the introduction of many social
policy reforms, has not received nearly as much attention.
Christina Ewig seeks to correct this imbalance in scholarly
research by presenting a case study of the multifaceted efforts to
reform the health sector in Peru under the Fujimori regime.
Second-Wave Neoliberalism combines top-down analysis of policy
formation with bottom-up analysis of policy implementation using
both qualitative and quantitative approaches--interviews and
ethnographic observations along with formal surveys. Ewig's
findings lead her to conclude that neoliberal health reforms have
brought greater social stratification and, in many ways, have
increased gender, racial, and class inequity. But the story is
complex, with real progress in some areas and surprising paradoxes
in others, such as feminist involvement in family planning policy
that resulted in a massive sterilization program targeting poor,
indigenous women.
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