Beyond the façade : instrumentalisation of the Zambian health sector

This dissertation is a response to an academic and popular discussion that painted a bleak picture of the African state and by extension the endeavour of development cooperation. It focuses on the Zambian health sector and the people who create it through their words and deeds. For health workers and their families the sector appears to be an avenue for upward mobility. For politicians it is a platform to further their political careers, while providing access to the resources needed to expand the presence of the state and ensure regime survival. The formal goals of providing quality health care to ordinary citizens appear to be of secondary importance. This insight into the Zambian health sector presents an African state as a dynamic human system undergoing its own historical development. It is different from what policy makers had promised or planned, or how other countries have evolved, but it is not necessarily a story of state failure or collapse.