<P> Recent studies have shown strong connections between SAPs and tuberculosis rates in developing nations . </P> <P> Countries with native populations living traditional lifestyles face with unique challenges in regards to structural adjustment . Authors Ikubolajeh Bernard Logan and Kidane Mengisteab make the case in their article "IMF - World Bank Adjustment and Structural Transformation on Sub-Saharan Africa" for the ineffectiveness of structural adjustment in part being attributed to the disconnect between the informal sector of the economy as generated by traditional society and the formal sector generated by a modern, urban society . The rural and urban scales and the different needs of each are a factor that usually goes unexamined when analyzing the effects of structural adjustment . In some rural, traditional communities, the absence of landownership and ownership of resources, land tenure, and labor practices due to custom and tradition provides a unique situation in regard to the structural economic reform of a state . Kinship - based societies, for example, operate under the rule that collective group resources are not to serve individual purposes . Gender roles and obligations, familial relations, lineage, and household organization all play a part in the functioning of traditional society . It would then appear difficult to formulate effective economic reform policies by considering only the formal sector of society and the economy, leaving out more traditional societies and ways of life . </P> <P> There are some serious problems in measuring the empirical success of Fund programs . It is extremely difficult to calculate the counterfactual; that is, what would have happened had the Fund not intervened . Even so, a study in the journal World Development found that the programs "often do not work", citing "high rates of recidivism, low rates of completion, and an insignificant catalytic effect on other capital flows". </P> <P> While both the International Monetary Fund (IMF) and World Bank loan to depressed and developing countries, their loans are intended to address different problems . The IMF mainly lends to countries that have balance of payment problems (they cannot pay their international debts), while the World bank offers loans to fund particular development projects . However, the World Bank also provides balance of payments support, usually through adjustment packages jointly negotiated with the IMF . </P>

The world bank (initially) and measures of gdp did not include the economic value of