COLONIAL RULE AND HEALTH INSTITUTIONS IN WEST AFRICA: Chiefs, Chefs, and WHO Rankings: Examining the Effects of Direct and Indirect Rule on West African Health Institutions

The right to health is vital. Therefore, its promotion should be in the best interest of all governments. Yet, not all health provision is the same, even amongst similar countries. Senegal and Sierra Leone are two West African countries with low levels of Human Development, and high levels of poverty. Nevertheless, Senegal has, according to the World Health Organisation’s Ranking of Health Systems, the 58th best health system worldwide, while Sierra Leone has the worst, at 191st. By asking the following question: Why did Senegal Perform Better than Sierra Leone in the World Health Organisation’s Latest Health Systems Rankings? This thesis aims to discover the factors leading to two countries with several similarities between them having such a stark difference in terms of their health systems. Through a review of theory and literature, this research explores the long-term effects of direct and indirect colonial rule. The goal here is to discover if the institutions built by the...Show moreThe right to health is vital. Therefore, its promotion should be in the best interest of all governments. Yet, not all health provision is the same, even amongst similar countries. Senegal and Sierra Leone are two West African countries with low levels of Human Development, and high levels of poverty. Nevertheless, Senegal has, according to the World Health Organisation’s Ranking of Health Systems, the 58th best health system worldwide, while Sierra Leone has the worst, at 191st. By asking the following question: Why did Senegal Perform Better than Sierra Leone in the World Health Organisation’s Latest Health Systems Rankings? This thesis aims to discover the factors leading to two countries with several similarities between them having such a stark difference in terms of their health systems. Through a review of theory and literature, this research explores the long-term effects of direct and indirect colonial rule. The goal here is to discover if the institutions built by the colonial powers affect the way modern-day states operate. The results indicate that indirect rule has led to Sierra Leone’s state fragmentation and institutional inefficiencies, while direct rule established ties between France and Senegal which undermine Senegal’s sovereignty. As a result, this thesis concludes that colonial institutions are a factor in the operations of modern-day governments and could therefore explain the difference in the results of Senegal and Sierra Leone’s positions in the WHO Rankings of Health Systems.Show less

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COLONIAL RULE AND HEALTH INSTITUTIONS IN WEST AFRICA: Chiefs, Chefs, and WHO Rankings: Examining the Effects of Direct and Indirect Rule on West African Health Institutions