Il decentramento sanitario e le politiche di integrazione tra le differenti tradizioni terapeutiche nel Ghana contemporaneo. Un sistema esclusivo o inclusivo?

Abstract

In Ghana, health decentralization processes are promoted since first years of 2000, and they are developed and organized on the base of administrative decentralization. Two of the most important health decentralization and health promotion projects are the Community Based Health Planning and Service (CHPS) and the National Health Insurance Scheme (NHIS), that are spreading within African continent with different forms. In this paper I want to outline the structure and the characteristics of these projects, to observe qualitative and quantitative influence they present in a local and rural context like Jomoro District (Western Region, Ghana), and to analyze the current management of Ghanaian Public Health. Nevertheless, it is relevant observing the integration politics between biomedicine and other therapeutic traditions presented in the social context, to outline a complete description of health system. Decentralisation and integration politics are important programmes promoted by Ministry of Health. Therefore, after a short presentation of legitimation processes of traditional medicine, I‟ll investigate the current professionalization politics of traditional healers and integration between different medical resources proposed by the Ministry of Health. This Kind of integration is very different from the “informal integration” present in a local context (Jomoro District), and induces to underline a radical dichotomy between politics and practices. At the end, the aim is to investigate reductionism of ministerial programs related to traditional medicine, apparent inclusionism of Ghanaian health politics, very distant from social actors‟ behaviors, and to debate on democratisation and privatization processes following current ri-definitions of health systems.