ABSTRACT
This chapter explores the concept of ideology. Then, it delves into the institutional and administrative problems that have historically bedevilled public health initiatives in Africa. Ideology is at the root of development policies in general and public health elements of town planning in particular. To the extent that urban planning is a function of the state, it is informative to appreciate the concept of ideology within a Marxian framework. Knowledge of pre-colonial planning and health practices and institutions in Africa hold enormous promise for contemporary efforts to improve living conditions on the continent. Efforts to shape the built environment would be non-existent in the absence of a need to improve public health. The fact that proponents of racial residential segregation as a health promotion/protection strategy were not persuaded by this preponderance of evidence is telling. It suggests that the racist ideology of the time and not science constituted the basis for public health policy making.
