The Paradox of State Retrenchment in Sub-Saharan Africa: The Micro-Level Experience of Public Social Service Provision

SummaryOver the past 30 years in Africa, neoliberal economic reform has meant a major retrenchment of the state provision of health and education with paradoxical local effects. Based on an analysis of 2005 Afrobarometer data, the study finds that the rural poor are more likely to use public schools and clinics than the urban, better-off. The data suggest that a two-tiered social service system now exists across many African countries where the rural poor may have little choice but to use public social services while the urban, better-off choose to pay for private alternatives. The author argues that concerns about ensuring absolute levels of access have obscured attention to the micro-experience and quality of social service delivery.