Pillay Y G, Bond P
Department of Health Policy and Management, Johns Hopkins University School of Hygiene and Public Health, Baltimore, MD 21205, USA.
Int J Health Serv. 1995;25(4):727-43. doi: 10.2190/YJU7-0HDM-7TYW-XLMF.
South Africa's first democratic government is today confronted with the challenge of recasting apartheid social and health policies, transforming a moribund bureaucracy's mode of governance, and restructuring a variety of public and private institutions, including the national Department of Health. In the attempt to redress racial, gender, and class inequities, enormous barriers confront health policy analysts and planners, progressive politicians, and activists within civil society who work in the field of health. This article sets the broad social policy context for the emerging strategies, documents some of the continuing inequities in the health sector, and recounts some recent experiences in one of the nine provinces (KwaZulu-Natal). to illustrate the difficulties and potentials that change of this magnitude presents under the prevailing conditions of neoliberal politics and economics.
南非的首届民主政府如今面临着诸多挑战，包括重塑种族隔离时期的社会与卫生政策、转变垂死官僚机构的治理模式，以及对包括国家卫生部在内的各类公共和私人机构进行重组。在纠正种族、性别和阶级不平等的努力中，卫生政策分析人士、规划者、进步政治家以及民间社会中从事卫生领域工作的积极分子面临着巨大障碍。本文为新兴战略设定了广泛的社会政策背景，记录了卫生部门持续存在的一些不平等现象，并讲述了九个省份之一（夸祖鲁-纳塔尔省）最近的一些经历，以说明在新自由主义政治和经济的当前条件下，如此大规模变革所带来的困难与潜力。
