Clara Carvalho

Participant Institutions

Universidad de Lleida, Espanha


Health has been from the beginning one of the major bases of development. On one hand health has been a principal objective, a fundamental component of the pursued increase in welfare, on the other, has constituted the necessary condition for making effective any developmental drive strategy, regardless of their orientation. After more than half a century of a health-development common ground, the risen challenges seem as important as the obtained achievements, to the point that research in the field is an imperative demand that calls for a multidisciplinary approach. Understanding these challenges requires taking into account that health, since the nineteenth century, has increasingly become one of the basic competence of the modern state, particularly in its democratic version. During the nineties, development and governance appeared closely related, establishing a governance development-health triangle which is precisely the core subject of this research project, in a specific scenario, Sub-Saharan Africa, and prioritizing the prevailing African medical pluralism attitude. Subject, scenario and approach gather together and optimize the previous experience of the research group.
In Africa, the association between health and development has been considered crucial given the complex health conditions of the continent. The inter-tropical situation explains its high biodiversity potential, which, in turn, triggers an equally high prevalence of a wide spectrum of diseases, so widespread or alarming such as malaria, AIDS or schistosomiasis, to name just a few. Moreover, the establishment of health systems in Africa has huge deficits, both in mobilized resources and in its accessibility, which reduce the efficiency of biomedicine (modern Western medicine), becoming inevitable, in the medium term, a medical pluralism scenario especially open. So far these African singularities have been considered a burden, but, given the impossibility of eliminating them in decades to come, the research project proposes, from a perspective of applied research, what are the chances of understanding, and reactivate them as factors of welfare of the populations.
In this sense, governance appears as a key concept, given that medical pluralism is much more than the unequal contact between recognized health systems (biomedicine and traditional medicine accepted by WHO): it gets embedded in the social and inevitably in the political notions and practices of Africans, male or female. By analyzing the ideological, economic and relational weave threaded between African medical and political systems (written also in plural, due to the legal and political pluralism that characterizes African contexts), the research project aims to provide knowledge for a better articulation of the various health actors: patients and their social environment, health professionals, traditional healers, public policy makers, traditional authorities, migrants and diaspora…
This clearer articulation wants to facilitate a better use of the African societies existing potentials in a context of limited resources, establishing the possibility for further recommendations for specific contexts.
At the same time, the research project aims to contribute to a more general reflection on the mechanisms which can make operative the intentions expressed in the WHO strategies for the twenty-first century (which, in turn, were derived from previous agreements such as the famous Alma -Ata in 1978), and can also review and evaluate their results as they happen.