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Periodical article Periodical article Leiden University catalogue Leiden University catalogue WorldCat catalogue WorldCat
Title:Impacts of socio-political upheavals on the health systems of sub-Saharan Africa, past and present
Author:Ingle, MarkISNI
Periodical:New contree: a journal of historical and human sciences for Southern Africa
Geographic term:Subsaharan Africa
health care
political stability
medical history
Abstract:Using life expectancy as an indicator for both personal well-being and the quality of the prevailing health system, the author tracks the process by which changing socioeconomic and sociopolitical conditions impacted on health and the development of health systems in sub-Saharan Africa over a span of some 600 years. The process involves complex impacts with feedback loops and an ongoing interplay between multiple causes and effects. Thus in each of the political timeframes under consideration - precolonial, colonial and postcolonial - the health outcomes of each phase gave rise to socioeconomic and sociopolitical conditions which in their turn had the effect of producing changed health outcomes which then impacted upon the subsequent phase. The equilibrium with nature that marked the precolonial 'Garden of Eden' era was disrupted following European and Arabian penetration of Africa from the mid-15th century onwards, setting off massive waves of migration that profoundly altered the landscape of African health care. In the colonial period, the chief catalysts for Africa's health development were the medical missionaries. Colonial administrations also eventually came to realize that the health of the indigenous people was in their own best interests. The colonial era ended with the distinct potential for ongoing improvements in health care in that, by and large, the institutions to deliver this were in place. During the postcolonial era sub-Saharan Africa's health systems regressed and HIV/AIDS threatens to destroy sub-Saharan Africa's health care capacity. Salvation could come from a new wave of de facto medical colonization, this time by the likes of the WHO, the World Bank, the UN, and the donor community. Notes, ref., sum. in Afrikaans. [ASC Leiden abstract]