This paper sets out the distinctive characteristics - both positive and negative - of NGOs as institutions for providing health care in Africa. It raises questions about environments conducive to NGO activity and how the role of NGOs can be encouraged without sacrificing their strength in the development process.

Non-governmental organizations (NGOs) are increasingly recognised as playing a significant role in the health sector in developing countries. This book examines the background to the growth both in the sector and interest in it, the strengths and weaknesses of NGOs and the arguments for and against their use for different aspects of the health sector. It focuses particularly on the relationship between the State and non-governmental organizations and the issues critical to the development of policies towards the sector.

Privatizing Health Services in Africa analyzes the disappearance of public health in the form of state services in Africa, and the growth of a private market in health care that will serve primarily an urban elite. Meredeth Turshen considers the implications of introducing private insurance in countries with growing unemployment, a shrinking formal job sector, and a lack of social security programs or other safety nets. She debates the pros and cons of shifting the delivery of health services to the nongovernmental sector in the context of new concepts of the role of the state. Many of the schemes to privatize the purchase and sale of pharmaceuticals reverse decades of United Nations work challenging the power of the multinational drug industry. Turshen weighs these policy changes in light of the World Bank's eclipse of the World Health Organization as the premier UN health policy agency. Until now, no book has disputed the World Bank's plans to privatize health care in Africa. This is the first book-length analysis of policy changes in light of monetarism and globalization. Throughout the book, Turshen examines the implications of privatization for gender equity. She also provides a case study of Zimbabwe and comparative material from Malawi, Mozambique, and Zambia. Her study makes a contribution to current debates on the impact of structural adjustment policies on health and the design of health services in the Third World.

To promote gender equity, expansion of the services sector should be encouraged. But this runs counter to the World Bank and IMF policy of encouraging the production of tradable goods (produced mainly in agriculture and less so in industry) to service debt. So direct government intervention is needed to promote investment in women's human capital.

Women play a much greater role in forestry in India than has previously been documented - and their involvement in forestry should be strengthened.