Reproducing Disparities in Global Health Agendas: The Contradictory Politics of Community Health Financing in Rural Africa

“Health for all”, “global health” and “planetary health” represent collective aspirations to overcome historically grown health disparities. Under these formulas, public health frameworks and programs have expanded international health infrastructures. However, efforts to universalize access to health infrastructures and to establish universal health care are continually undermined be the steep urban-rural disparities in access to coverage, to infrastructures and medial services. Despite the progress, no convincing solution has been found to address the dire rural inequality and peripherality in Global South countries, especially in African countries. Why does planetary health not translate effectively to rural African settings? How do international organizations, national governments and epistemic communities tackle the problems of rural health coverage and capacities in Africa?

In this paper, I engage with the dynamics of community health financing in West and East Africa. Drawing on a sociology of knowledge perspective and on Bourdieu-inspired practice theoretical ideas, I contend that the aspirations of community health financing in Africa as a tool of UHC are seriously flawed and mainly follow the logic of global developmentalism. They do not seriously consider the limitations of present community health frameworks, at all. Across these African cases, I demonstrate that the unwillingness of inability to address the present policy weaknesses is also due to a lack of academic knowledge production on the matter. There are serious gaps in the discourse on UHC and community health financing in the scholarly literature in the matter, as the latter also mainly operates in a developmentalist logic and is dominated by the interests of development studies in public health. Together, the paper aims to show that the everyday flaws of earlier global health agendas tend to be reproduced under the contemporary planetary health agenda and calls for a serious reconsideration of rural African health concerns in globalized health debates.