This project will investigate the impact of state economic crisis on mobilizations around health and expressions of medical pluralism in Senegal. Relying on both critical and interpretive perspectives in anthropology, the study will examine how the state's increasing inability to provide health care has caused a shift in health resources and sparked innovative responses to disease, including the creation of new "hybrid" medical structures and practices. Although the research focuses on Senegal as a case study, the project is situated within the overarching context of global trends toward structural adjustment programs (SAPS) and the downsizing of national social services. As structural adjustment programs transform national and regional economies and limit social welfare programs, social actors must respond to these changes. I will employ an actor oriented approach to analyze how individuals and groups in Senegal perceive the inadequacies of state health services and how they utilize changing health resources to cope with disease. I will explore this problem on national, regional and local levels by researching the perspectives and strategies of Ministry of Health staff as well as those of two local communities, one rural and one urban. By addressing the problem of therapeutic choice and medical pluralism within the context of state crisis in Africa, I expect that this research will offer new insights and greater coherence to our understanding of how health-seeking strategies and behavior are situated within larger socio­economic realities and contexts.