Africa's Post-Conflict Formal and Informal Health Institutions

Overview of Africa's Post-Conflict History and Colonial Legacies

Colonial legacies persist in Africa despite the post-colonial era (Austin, 2010). These legacies have continued to shape post-conflict Africa's history. In Africa, there has been no single unifying factor bringing individuals together, primarily because of the communal nature of society throughout the continent. Community exists and can be found everywhere in Africa. Structural, dramaturgical, and institutional factors in the formal institutionalization of health care in Africa have emerged as a result of investment, development, and political stability (Ratcliffe, 2013). The relationship among cultural traditions, the laws of society, and symbolic boundaries has served to create the structural meanings behind formal institutions; the expressive dimension, communicative properties, and interaction of these elements make up the dramaturgical; and the actors and organizations themselves constitute the institutional. An example of this dynamic can be seen in Nigeria.

Structurally, dramaturgically, and institutionally, Africa has undoubtedly been impacted by the West over the past few centuries. It has not been untouched by the modern era, and in nations like South Africa one can see just how much Western influence has shaped African society (Bratton & Van de Walle, 1997). Yet other parts of Africa — such as Eritrea — offer a quality of life for their people that, in some respects, compares favorably to that found in South Africa (Morrison & Stevenson, 1972; Ratcliffe, 2013). This may be because of a closer adherence to native dramaturgical and structural meanings. To make such an argument, however, one must define what is meant by these meanings (Southall, 2003). To do that, one must examine the lives of the people in question — what they themselves value and how well they succeed in attaining those values — rather than applying external values shaped by hundreds of years of experience on another continent and assuming those values will hold significance for the people in question (Southall, 2003). To have a sense of the rules of a community, one must have a sense of the people themselves (Afro-centric Alliance, 2001). There is a community basis for development that is entirely missed by progressive reformers who seek to modernize Africa in accordance with Westernized development models.

Africa has its own mythological leaders and figures. As Prempeh (2007) points out, "the assault on constitutionalism was spearheaded by Africa's larger-than-life founding fathers, leaders like Osagyefo (Victorious Warrior) Kwame Nkrumah (Ghana), Mwalimu (The Teacher) Julius Nyerere (Tanzania), le Grand Silly (Elephant) Sékou Touré (Guinea), Ngwazi (Great Lion) Kamuzu Banda (Malawi), and Mzee (Esteemed Elder) Jomo Kenyatta (Kenya)" (p. 472). These leaders' mythologies were established not necessarily by a yearning growing out of customary and traditional groups who believed their traditional way of life could be facilitated by such figures' political success, but rather by other members of a burgeoning political class — African activists and politicians emerging to fill a void in leadership at the governmental level as the era of colonization came to an end. Prempeh (2007) argues that "nationalist mythology and historiography had invested these leaders with messianic attributes for their role in wrestling sovereign statehood from the jaws of European colonialism" (p. 472). The result is a post-colonial and post-conflict African narrative that functions, in effect, as a form of political propaganda.