Democratic demands and social policies : the politics of health reform in Ghana

It is commonly assumed that the advent of democracy tends to bring about social welfare improvements. Few studies, however, have examined empirically the impact of third-wave democratisation processes on social policies in developing countries, particularly in sub-Saharan Africa. Through a diachronic comparison, this paper examines the effects of Ghana's democratisation process on the evolution of its health policy. It shows that the emergence of democratic competition played an important role in the recent adoption of a crucial health reform. A policy feedback effect on politics and a process of international policy diffusion were additional but secondary factors.