<P> For example, if a government cuts education funding, universality is impaired, and therefore long - term economic growth . Similarly, cuts to health programs have allowed diseases such as AIDS to devastate some areas' economies by destroying the workforce . A 2009 book by Rick Rowden entitled The Deadly Ideas of Neoliberalism: How the IMF has Undermined Public Health and the Fight Against AIDS claims that the IMF's monetarist approach towards prioritizing price stability (low inflation) and fiscal restraint (low budget deficits) was unnecessarily restrictive and has prevented developing countries from being able to scale up long - term public investment as a percentage of GDP in the underlying public health infrastructure . The book claims the consequences have been chronically underfunded public health systems, leading to dilapidated health infrastructure, inadequate numbers of health personnel, and demoralizing working conditions that have fueled the "push factors" driving the brain drain of nurses migrating from poor countries to rich ones, all of which has undermined public health systems and the fight against HIV / AIDS in developing countries . A counter-argument is that it is illogical to assume that reducing funding to a program automatically reduces its quality . There may be factors within these sectors that are susceptible to corruption or over-staffing that causes the initial investment to not be used as efficiently as possible . </P> <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>

When was structural adjustment program introduced in nigeria