The exact implications of implementing structural adjustment in the social sector in Africa have been hotly disputed and have polarized researchers. Using an empirically-grounded longitudinal study of urban and rural households in Zimbabwe, this report examines the consequences of market-based economic reforms. It focuses on observed changes in the household economy in urban and rural Zimbabwe. The study offers extensive documentation and analysis of shifts in the health status and behavior of the people, as well as changes in health outcomes, especially as they relate to nutritional status and child mortality. The authors make the case for policy reforms that could safeguard the health and well-being of people at a time of continuing economic decline.