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Health News of Wednesday, 18 March 2015

Source: theguardian.com

Can democracy lead to development, or is it the other way around? The question remains far from settled, and the stakes have never been higher. Most countries today are formal democracies; two out of every three people live in such countries. Yet, there is growing disillusionment about the way democracy works, and concerns about whether it can deliver in terms of social and economic wellbeing. The phenomenal success of countries like China and other Asian tigers in lifting people out of poverty has also increased the appeal of authoritarian models of development.

This is what makes the case of Ghana so compelling. Over the past two decades, it has experienced one of the worlds most successful transitions to multiparty democracy, and it is one of the few democracies emerging from the third wave of democratisation that has taken root. This is no small achievement, especially in a multi-ethnic setting.

Since 1992, the country has held six elections, and power has been transferred from government to the opposition on two occasions. It has also experienced what several observers call an explosion of political voice, with the growth of an active and engaged civil society that includes professional associations, NGOs, unions, thinktanks and the media.

At the same time, the provision of basic services, especially health and education, has improved dramatically. In 2003, Ghana became one of only a handful of countries not part of the Organisation for Economic Cooperation and Development (OECD) to provide free and universal health coverage (under the National Health Insurance Scheme); and between 1998 and 2008 child immunisation rates soared from 19% to 70%. In 2007, it became the first country in sub-Saharan Africa to make pre-primary education compulsory, and the number of kindergartens doubled from 6,321 to 13,263 between 2001-02 and 2010-11.

According to research from Afrobarometer, three out of four Ghanaians are satisfied with the quality of their countrys democracy and what it can deliver an approval rating that would be the envy of many other countries.

What has driven this progress in political voice, health and education in Ghana?

Ghanas progress is rooted, in part, in its history, and in particular in the way that state-society relations have evolved over time and the nature of political competition, as well as in the kind of socioeconomic transformation that the country has experienced since independence.

Ghana has a long history of tolerance and accommodation. State formation processes and state-society relations based on the promotion of social cohesion and a unified Ghanaian identity emerged early on, and the notion of a social contract linking state and citizens has been an integral part of its state-and-nation-building project from the start. Leaders and both formal and informal institutions have fostered inclusion and incorporation in ways that transcend narrower ties based on kinship or ethnicity. And an expanding, more urban, and increasingly educated middle class has been actively engaged in political processes and is deeply committed to the countrys democratic values.

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Ghana's democracy is driving great progress in health and education