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Development and Women's Reproductive Health in Ghana, c. 1920 - 1982



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Ashford, Holly 


This thesis is a social history of women’s reproductive health in Ghana. It asks how ‘development’ impacted on women’s reproductive health work, and women’s experiences of healthcare, between 1920 and 1982. It recognises development as a discourse, which is used to legitimise the actions of individuals, organisations and governments. Development is malleable and it is plural, in its meaning. It is a label for something which is practiced and it is an aspiration to be reached. Development discourse was used to justify colonial government spending on maternal and child welfare, but equally to hand these services over to populations in the name of ‘self-help’. It was used to legitimise a pronatalist approach under Nkrumah, and later as a core reason to implement population control.

Using a combination of oral and documentary sources, I have mapped changes and continuities in women’s reproductive health work. I argue that development has consistently shaped the availability of women’s reproductive health services, and the way in which it has been carried out. This has meant that women’s health as such has rarely been a core priority in reproductive health programmes. Oral histories have been essential in teasing out women’s experiences of their reproductive health, which development discourses often gloss over.

Through looking at implementation over a sixty-year period, we can clearly see the relationship between development and women’s reproductive health both under colonialism, and in Ghana as an independent country. I begin by examining the humanitarian and economic impulses that drove early colonial development, move on to the ‘welfarist’ late colonial state through which imperialists sought to defend their positions, and then examine the (economic) nationalism of independent Ghana: all these phases were characterised through attention to reproduction.

This thesis covers six themes: demography and development; developmental humanitarianism; social development; nationalist development; family planning and development; and community development. Each of these themes constitutes a chapter of this thesis, and they run chronologically. Tying them together is the fact that each of these histories is deeply intertwined with women’s reproductive health.





Austin, Gareth


Ghana, Reproduction, Health, Gender, Development


Doctor of Philosophy (PhD)

Awarding Institution

University of Cambridge
AHRC (1797031)