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Is paying for health care culturally acceptable in sub-Sahara Africa? Money and tradition


  • van der Geest, Sjaak


In 1987 UNICEF launched the so-called Bamako Initiative, which has as its main objective to improve the sustainability of primary health care in Africa by making people pay for it. The question is raised whether paying for health care is culturally acceptable in African communities. The author argues that 'money' is not a new phenomenon in Africa and that paying for goods and services does not need to conflict with existing traditions of reciprocity in the field of health care. Money is an artifact which is culturally incorporated in a creative manner to satisfy specific needs. Cultural objections to paying for health care, therefore, are unlikely to exist, but how payment should be realised in an effective and just way is another question.

Suggested Citation

  • van der Geest, Sjaak, 1992. "Is paying for health care culturally acceptable in sub-Sahara Africa? Money and tradition," Social Science & Medicine, Elsevier, vol. 34(6), pages 667-673, March.
  • Handle: RePEc:eee:socmed:v:34:y:1992:i:6:p:667-673

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    Cited by:

    1. Chukwuani, Chinyere Mercellina & Olugboji, Akindeji & Akuto, Edward Erdorga & Odebunmi, Akim & Ezeilo, Ezenta & Ugbene, Emmanuel, 2006. "A baseline survey of the Primary Healthcare System in South Eastern Nigeria," Health Policy, Elsevier, vol. 77(2), pages 182-201, July.


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