| Summary: | This is a study of the long-term political economy of public health work in northern Ghana, and of the contingent application of medical knowledge under different political regimes. Covering the period from 1900 to 2000, the thesis asks how the north and its people's enduring peripherality - defined in various ways - shaped the evolution of public health institutions and conditioned the state's attention to particular diseases. It assesses key public health transitions across the century, including the creation of the north's Native Authority health system in the 1930s, the entrenchment of church authority for healthcare in the 1950s, and the government's gradual cession of medical oversight to international organisations from the late 1960s, a process which was partially reversed in the late 1990s. It examines specific disease control programmes against sleeping sickness, onchocerciasis, and guinea worm, for what they reveal about the social history of medical work on the margins of the state, and about the political contexts for population-level health interventions. Colonial-era tsetse control inadvertently contributed to the serious prevalence of onchocerciasis in the north at independence, and this high prevalence of onchocerciasis made northern Ghana a focus of international health fundraising ahead of the WHO Onchocerciasis Control Programme, which began in 1974. In the urban south, guinea worm disease was substantially reduced in the early twentieth century, but in the north the disease only received concerted attention from the 1980s. In the historical literature on health in Ghana, there are few studies which adequately disaggregate the north and its particular experiences of public health work. Using sources from northern regional archives, the archives of the World Health Organisation, and interview testimony from government health officials and village communities, the thesis aims to make a contribution to this area.
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