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Authoritarian Survival and Health Care Provision in Post-Soviet Central Asia

Johnson, Erica

What is replacing the comprehensive Soviet safety net and health care restructuring in post-Soviet authoritarian regimes of Kazakhstan, Kyrgyzstan, and Uzbekistan? I explore the conditions under which authoritarian regimes use health care provision as part of their survival strategies and how authoritarian regimes incorporate nongovernmental organizations in health care provision. I argue that two factors shape authoritarian states' health care strategies: elite perceptions of political contestation shape state health care spending decisions and economic self-sufficiency determines whether states have privatized health care service provision to replace or supplement government services and structures the nature of state-NGO relations. The resulting health care strategies are not static, but evolve as political and economic pressures change. Rather than three countries over a 20-year time period, I analyze specific periods and cycles within each country to capture the dynamic nature of state health care strategies. I find that authoritarian regimes take seriously the role of societal actors as sources of political competition, constituencies to be won over through social welfare provision, and as partners or competitors in meeting the population's social welfare needs.

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Academic Units
Global Health Research Center of Central Asia
Publisher
Columbia University
Published Here
October 3, 2011

Notes

First Annual Conference, Culture, Religion, and Communications Unit of the Global Health Research Center of Central Asia, "Healing Paradigms and the Politics of Health in Central Asia," Columbia University, April 8, 2011.

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