The development of colonial health care provision in Ghana and Côte d’Ivoire: ca. 1900–55

ABSTRACT Colonial administrations introduced various social infrastructures in Africa. This paper analyses and compares the development of colonial governments' health care provision and policies in Ghana and Côte d’Ivoire from circa 1900 to 1955. Using qualitative and quantitative information from colonial reports, a new dataset captures the development of four factors relevant to these aims: health care expenditures, health care facilities, medical staff, and patients. Deflated health care expenditures per capita were found to be higher in Ghana than in Côte d’Ivoire in almost all years. The number of health care facilities per capita was larger in Côte d’Ivoire than in Ghana, and facilities were more geographically dispersed. Ghana had a lower number of medical staff per capita than Côte d’Ivoire as of the 1920s. Medical staff from Côte d’Ivoire formed the majority of the staff base as early as the mid-1910s. Finally, the analysis shows that the number of patients treated in health care facilities in Ghana was low until the 1920s, and took off as more facilities became available during the 1940s. These findings provide evidence that even two countries that are relatively similar (apart from their colonial history) can have different colonial health care trajectories.