The current global pandemic that has been sweeping across the globe has forcefully brought into the limelight the importance of good health for all. Yet, millions of people around the world lack access to even basic preventive and curative health infrastructures, many of whom are living in Sub-Saharan Africa (henceforth Africa) (World Health Organization (WHO), 2018). Despite the historically heavy health burden in Africa, little attention has been devoted to understanding both the establishment and effectiveness of medical services in Africa during the colonial period.
In this paper, we aim to understand the historical roots of public health care provision in British colonial Africa from a comparative perspective, using annual medical reports for 12 former British colonies between 1900-1960. We chart total healthcare expenditure and revenue per colony to investigate differential spending on curative versus preventative public health measures. The overall budget devoted to healthcare, and the distribution of expenses over various categories and for different race groups provides insight to the importance attached to healthcare provision, and the different priorities within the sector.
Further, we track the number of trained staff and in the employment of African medical personnel to shed light on the quality of medical care and the importance of African input in the supply of government and non-government services. We examine the quality of healthcare provision further by considering the geographical coverage of hospitals and other medical facilities, and the number of European and African patients treated per hospital. We relate variations found to differences in geographical and disease environments, differences in country specific health care policies, demographic variation and population densities, and the structure of the colonial economies.
(jointly with Jeanne Cilliers)