Reduce expenditures on health, education, etc. Literacy rates go down. Poorly-educated generation not equipped for skilled jobs Higher fees for medical service mean less treatment, more suffering, needless deaths. Women, already overburdened, must provide healthcare and caretaking for family members. Reduce budget expense by trimming payroll and programs.
Small farmers sell land, work as tenants or move to worse lands.
Reduce government expenditures supporting reduced cost of bread, petroleum, etc. SAPs are anti-democratic in more than one way. The institutions are correct in saying that the plans are formulated in part, and agreed to, by the governments. If they don't cooperate, the consequence can be a complete cut-off of credit because other lenders follow the lead of these institutions. SAPs encourage instability in democratic countries by forcing elected governments to institute measures which make them illegitimate among their people.