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Periodical article Periodical article Leiden University catalogue Leiden University catalogue WorldCat catalogue WorldCat
Title:Non-State actors and universal services in Tanzania and Lesotho: State-building by alliance
Author:d'Arcy, Michelle
Periodical:Journal of Modern African Studies (ISSN 0022-278X)
Geographic terms:Lesotho
Subjects:primary education
education fees
educational policy
health care
health financing
health policy
aid agencies
External link:https://www.jstor.org/stable/43303984
Abstract:In recent years over half of all African States have reintroduced some form of universal basic service provision, though many more have done so for education than for health care. Most explanations of these developments have emphasized the importance of demand side factors associated with democratization. This paper argues that while democratization has been important in generating pressure for reform, alliances with actors outside the State - such as donors and non-State service providers - have been the critical enabling factor, allowing weak States to overcome their capacity constraints and respond. Two illustrative case studies show how variation in alliance opportunities has led to differences in outcomes both between social sectors and across countries. An intersector comparison of health and education policy in Tanzania shows how a difference in donor policy preferences between sectors - donors having converged behind the principle of universal primary education but not universal health care - has led to variation in alliance opportunities and hence policy outcomes. A 'least likely' case of health care reform in Lesotho shows how an alliance with a non-State provider has made difficult reforms possible. Bibliogr., notes, ref., sum. [Journal abstract]