Title

SOCIAL CLASS, THE STATE, AND MEDICAL DECOLONIZATION IN GHANA: A STUDY IN THE POLITICAL ECONOMY OF HEALTH CARE

Date of Completion

January 1985

Keywords

Sociology, Social Structure and Development

Degree

Ph.D.

Abstract

This dissertation examines the persistence of the colonial legacy of medical maldistribution (that is, uneven distribution of medical personnel, facilities, and budgetary allocations against the background of demographic, morbidity, and mortality patterns) in post-colonial Ghana. It focuses on Ghana's role and status in the capitalist world-system, the ideological and political nature of the Ghanaian state, and internal class structure/relations as the contextual elements of a political economy perspective for analyzing the problem. The central questions posed are: What does the post-colonial period have in common with the colonial period that continues to reproduce the uneven distribution patterns in health care? What happened after independence that apparently aborted the popular expectation of decolonization? What is the best way to conceptualize the continuity between the colonial and post-colonial situations? And what, above all, are the pre-conditions for decolonization in contemporary Ghana?^ Interviews with government and health officials in Ghana, and analysis of secondary data constituted the main methods of study. The case-study approach was combined with a cross-national, comparative perspective (focusing on The People's Republic of China, Cuba, and Mozambique) to address the problem.^ The study found that throughout the post-colonial period in Ghana, medicine and health care generally have been subordinated to the accumulation needs of capital and the legitimation concerns of the state. The maintenance and consolidation of the colonial health care legacy are found to be directly related to the structural weaknesses of the local ruling classes vis-a-vis foreign capital. It is concluded, from cross-national experiences and from developments in Ghana itself, that the possibilities and prospects for medical decolonization in Ghana are inextricably linked to the evolution of a political culture and a sustained process of economic transformation in which the laboring classes and their interests will acquire a predominant place. ^