RHI Seminar: The Determinants of Spatial Diffusion of Colonial Health Care Facilities in Ghana and Côte d’Ivoire: ca. 1900-1955

Abstract:

Colonial rule in Africa introduced colonial health care systems in response to Africa’s disease environment (Hartwig & Patterson, 1978, p. 16-17). Existing research suggests that the presence of Europeans and the economic importance of locations were influential factors in deciding where a colonial health care facility was set up, at least in the early decades of the 20th century. In later years, colonial policy widened its view on health care, as exemplified by the British Colonial Development act and the French Fonds d’Invetissement pour le Developpement Economique et Social (FIDES). This paper analyses the endogeneity of the introduction of colonial health care systems in Ghana and Côte d’Ivoire. It answers the research question: which locations were included in colonial health care provision, and why? Ghana and Côte d’Ivoire form an interesting setting for studying the endogeneity of the introduction of colonial health care facilities. The countries have a different colonial experience, but are neighbouring countries in West Africa with similar geography and climate (Cogneau & Rouanet, 2011, p. 57). Ghana was colonized by the UK, and was one of the first African countries to gain independence in 1957. Côte d’Ivoire on the other hand was part of the colony of French West Africa from 1893 to 1960.

Using annual data on the locations of colonial health care facilities in Ghana and Côte d’Ivoire newly gathered from primary source material, I consider different factors that may have influenced the decision to invest, or to not invest in a location’s colonial health care system. Existing literature suggests several factors, including population density, urbanization, European population, disease prevalence, missionaries, geographical factors and economic activities. Information on these factors are gathered from existing databases whenever possible, and supplemented with new datasets if necessary. An important source of existing data is the work by Jedwab, Moradi & Meier zu Selhausen (2022). Amongst others, their dataset incorporates information on malaria prevalence by Depetris-Chauvin and Weil (2018), tseste fly ecology by Alsan (2015), navigable rivers and lakes by Johnston (1915), railroads by Jedwab and Moradi (2016), mines by Mamo, Bhattacharyya, and Moradi (2019), population from HYDE, land suitability for several cash crops by FAO and their export values by Frankema, Williamson and Woltjer (2018). Jedwab, Meier zu Selhausen and Moradi (2022) also compute distance to coast, and include information on area size, rainfall, altitude, ruggedness, and soil fertility. I combine the information from existing datasets at the grid cell level with grid-level information on colonial health care facilities, and use it in a comparative econometric (spatial) analysis to answer my research question.