The National Action Plan for Primary Health Care, a planning document of the Sierra Leonean Ministry of Health for the restructuring of the country's rural health services, is analyzed in its social, economic, and historical context. It appears to be an attempt of the national government to gain control over the highly devolved health care delivery system, but the state has neither the political will nor the power to achieve this goal. The utility of the document is therefore in doubt, which raises two important questions: Whose interests does this plan serve, and at whose cost?
Get full access to this article
View all access options for this article.
References
1.
National Action Plan on Primary Health Care. Ministry of Health, Government of Sierra Leone, Freetown, 1984.
2.
WaterstonA.Development Planning. The Johns Hopkins Press, Baltimore, 1965.
3.
BryantC., and WhiteL. G.Managing Development in the Third World, pp. 230–232. Westview Press, Boulder, Col., 1982.
4.
WHO/UNICEF. Report of the International Conference on Primary Health Care, Alma-Ata. WHO, Geneva, 1978.
5.
BanerjiD.Hidden menace in the Universal Child Immunization Program. Int. J. Health Serv. 18(2): 293–299, 1988.
6.
WalshJ. A., and WarrenK. S.Selective primary health care: An interim strategy for disease control in developing countries. N. Engl. J. Med.301(18): 967–974, 1979.
7.
NavarroV.A critique of the ideological and political position of the Brandt Report and the Alma-Ata Declaration. Int. J. Health Serv. 14(2): 159–172, 1984.
8.
World Bank. World Development Report 1988. Oxford University Press, New York, 1988.
9.
MitchellP. K.Sierra Leone: Physical and social geography. In Africa South of the Sahara, Ed. 15, p. 820. Europa Publications, London, 1985.
10.
SobhanR.Public enterprise and the nature of the state. Devel. Change10(1): 23–40, 1979.
11.
LukeD. F.The political economy of an African public enterprise: A longitudinal case study of the administrative and economic operations of the Sierra Leone Port Authority. Public Admin. Devel. 4(2): 171–185, 1984.
12.
MacCormackC. P.Primary health care in Sierra Leone. Soc. Sci. Med.19(3): 199–208, 1984.
13.
GrieveM. J.Policy Processes and Socio-Economic Development: Pharmaceuticals in Sierra Leone. Paper presented at the 14th Annual Conference of the Canadian Association of African Studies, Antigonish N.S., 1984.
14.
SibleyJ. C.HamiltonJ. D., and Adcniyi-JonesC.The University of Sierra Leone and the Development of National Health Services Feasibility Study. World University Services (Canada), unpublished, 1976.
15.
AzaryaV., and ChazanN.Disengagement from the state in Africa: Reflections on the experience of Ghana and Guinea. Comp. Stud. Society History, January 1987, pp. 106–131.
