Suchergebnisse

The structural adjustment programme imposed by the World Bank and IMF in the face of the serious economic crisis that confronted African states in the 1980s resulted in severe cuts in state spending on social services including health. State failure in the provision of social services led to the externalisation of responsibility for health and the proliferation of actors working in the field of health across the continent. Despite the positive and negative consequences of this development on Africa, the debate about the role of external actors in health care delivery in Africa has dwelt extensively on the degree they should participate neglecting the emphasis on how they participate, under what conditions and with what consequences. Using qualitative data techniques, this article examines the involvement of external actors in health care delivery in Africa illustrating the nature, pattern, dimensions, and dynamics of such engagements in the context of popular concerns with good governance. It found that governance challenges constitute a serious obstacle to better health outcome in Africa. It posits that African states can only maximise their gains from external assistance for health if they take leadership in coordinating health activities in their countries within the context of a comprehensive national health plan.

From the outset the founding fathers of Economic Community of West African States (ECOWAS) recognized the relevance of integration in the social sector based on the conviction that intense cooperation in the economic and political sectors alone will not bring about lasting regional integration. For instance, the ECOWAS treaty of 1975 and revised treaty of 1993 had the promotion of social progress and collaboration in the social field as one of the objectives of the community. Yet scholars have not given it the deserved attention. This paper therefore represents an attempt to assess the extent to which the West African Health Organization (WAHO), a specialized health agency of ECOWAS, has contributed to regional health integration in West Africa. It argues that regional integration and cooperation should not be geared solely towards economic and political purposes. It also examines the achievements as well as the major challenges confronting WAHO. It concludes that regional health integration is no longer an option but an imperative for West African countries to meet their common health challenges.