Como introdução às motivações e ao interesse do tema, parece-nos oportuno esboçar uma reflexão preliminar sobre a questão. Ao alcançar a independência, quase todos os Estados africanos herdaram apenas estruturas administrativas embrionárias nos diferentes domínios. Nesse contexto, a Costa do Marfim dispunha apenas de um sistema de saúde bastante limitado. Isso traduzia-se numa fraca cobertura médica em termos de medicina moderna. No entanto, nas localidades dotadas de estruturas sanitárias, o tratamento das doenças era da exclusiva responsabilidade do Estado. Por outras palavras, nas décadas de 1960 a 1980, nas estruturas sanitárias da Costa do Marfim, como em toda a África, o custo dos cuidados de saúde era da responsabilidade do Estado, mas com a ajuda de algumas clínicas privadas. Esta dinâmica do Estado providente foi posta à prova durante a década de 1980 a 1990. Com efeito, a deterioração dos custos das matérias-primas mergulhou as economias dos países em desenvolvimento numa grave recessão económica.
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