Health Policy in Anglophone West Africa: Examining the Impact of Colonial Influence and International Financial Institutions

After attaining independence, several African governments laudably aimed to provide their citizens with substantially free health care. However, they continued the colonial legacy of focusing on curing illnesses, and hospitals remained the central location for delivering care. Over time, this hospital-based curative approach became too expensive for African governments to sustainably finance and did not align with the revenue generation capacity of African economies. In an attempt to procure well-functioning economies, the World Bank and International Monetary Fund advocated for the introduction of several market-oriented structural adjustment programs that further constrained the already-floundering public health sector within the region. The combined effect of the foregoing is that the health care delivery system within the region, particularly in public health facilities, is severely deficient, and the disease burden remains high. In essence, the dominant curative medical model has proven inadequate in meeting the main health needs of African populations, as it cures diseases for some but fails to promote health for all. In response, this article emphasizes the need for Anglophone West African governments to critically evaluate their health systems and initiate the development and implementation of health policies suited to their contexts and tailored to the needs of their citizenry. This approach, it argues, would not only improve the health system and health outcomes within the region but also aid in rebuilding trust between African governments and their populations.