These efforts to create compensatory mechanisms within adjustment programmes were among the first signs of a significant new shift in the overall approach of international financial institutions and Northern governments to stabilization and adjustment. Pressure came not only from angry citizens of Third World countries, who took to the streets in what came to be known as "IMF riots", but also from concerned citizens' groups and non-governmental organizations engaged in grassroots development assistance in Third World countries. Evidence of worsening social conditions, brought to the attention of the international community by bilateral and multilateral agencies (among which UNICEF assumed a leading role), also played an important part in encouraging a policy shift. Threats to demand serious organizational and administrative "adjustment" efforts within the World Bank and the International Monetary Fund themselves, and to tie these efforts to a possible reduction in their resources, underlined the advisability of rethinking the lending practices of these institutions.

The emergence in the early 1990s of groups within international civil society which could claim to have a legitimate voice in shaping the approach of multilateral institutions to stabilization and adjustment was unprecedented. It represented a challenge not only to the prevailing ideology of development, but also to the legitimacy of a style of international economic policy-making which had become highly technocratic and secretive.