Extractive Legacies: How Post-colonial States Struggle with Institutional Corruption

This briefing examines institutional corruption using Ghanaian healthcare as a case study, and explores path-dependency on the African continent more broadly. This article was written by Vrinda Rastogi and edited by Tanvi Sureka.

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Introduction

Why do some states sustain prosperity while others struggle to build stable growth and effective public institutions? Development has long been contested in global debates, often reduced to rigid categories that imply cultural deficiency in the “developing world.” This framing is misleading. A more convincing explanation traces how colonial rule reshaped political and economic institutions through coercion, exclusion, and intensive resource extraction—structures that did not simply disappear at independence. Rather than reflecting inherent “backwardness,” many governance failures in post-colonial states are reproduced through historical and structural processes that continue to shape state behaviour and incentives. One enduring legacy is institutional corruption: when colonial administrations governed through patronage, unequal access to resources, and extractive bureaucracies, they entrenched practices that later became embedded in the post-colonial state.

Therefore, what then becomes more important is to acknowledge that post-colonial developmental states being trapped in the cycle of underdevelopment and weak governance is, in fact, reproduced via deeper structural and historical processes that continue to shape institutional behaviour. Developmental states with colonial histories have struggled with corruption being a strong force driving the growth of the country in the wrong direction. Ghana offers a useful case for examining how these extractive legacies can persist within public institutions, particularly in the healthcare sector, and how they distort service delivery and state capacity today.

Case study: Corruption within Ghanaian Healthcare

Ghana provides a particularly useful case because it was the first sub-Saharan African country to gain independence in 1957 and is often presented as one of Africa’s more stable democracies. Yet despite this relative political stability, Ghana continues to face high levels of corruption, particularly in critical public sectors such as healthcare. Recent evidence shows widespread bribery, procurement irregularities, and every day “petty corruption” within the health system, disproportionately affecting the poor and marginalised. These patterns suggest that corruption is not an isolated problem of individual behaviour but rather embedded in institutional routines and power relations.

Drawing on Mushtaq H. Khan’s conception of corruption as a “process rather than an outcome,” this essay moves beyond individual acts of misconduct and instead focuses on how historically produced institutional norms enable corrupt practices to persist. The central argument is twofold: first, colonial rule created institutional structures prioritising extraction and control over public welfare; second, these structures weakened state capacity and accountability, generating long-term vulnerability to corruption in post-colonial governance. Ghana’s healthcare system illustrates how colonial legacies continue to shape contemporary development outcomes, revealing broader insights into institutional persistence in post-colonial states within the international system.

Path-dependent Africa

To understand this theoretically, path dependency provides a powerful lens to explain why post-colonial institutions remain resistant to reform. David (2000) explains path-dependency as a process in which long-term outcomes depend on historical sequences rather than current efficiency. Therefore, once the institutions become “locked in” to a particular trajectory, it is very difficult to mold them differently. This happens because they generate self-reinforcing mechanisms, making it difficult to escape the loop of dysfunctionality.

African states have experienced a similar trajectory over the years, where the economic crisis was triggered due to over-dependence on international aid and foreign support, eventually leading to a weak government structure. A.G. Frank’s Development of the Underdevelopment explains by rejecting the idea that underdevelopment is original or natural, underdevelopment is historically produced, since today’s developed countries were once undeveloped but never underdeveloped. This historical production of underdevelopment aligns with James Mahoney’s theory of path dependence in post-colonial developmental states of Latin America, where a chain of events rooted in the colonial past acquires deterministic properties. Hence, it is argued that institutions like corruption are one of the biggest aftermaths of oppressive imperial rule, often referring to colonial administrations that were ‘designed to rule, not to serve’ and had a higher possibility of failing to set up their own government in the long run. This determines that corruption had deeper roots before the formal independence of the country, hence explaining its presence in the current government structure.

The idea of applying the Western route to development has been a common phenomenon in developing countries. This eventually leads to what scholars call isomorphic mimicry. It is a term used to address how states that are still developing often try to copy or mimic the states that are successfully developed, fully achieving their intended developmental outcomes. This is because states are often faced with international pressure to establish democracies and strong institutions early on. This often impacts their organic process of building the state from scratch. This constructed pressure often pushes the early developmental states to make decisions in a hurry, eventually reproducing a weak and dependent state struggling to manage. Ultimately, lacking institutional capacity because of their containment under colonial rule, they end up mimicking the development of already developed states.

Colonial Reflections on Health and Corrupt Institutions

Looking into Ghana’s health system to draw links between underdevelopment and corruption provides an understanding of how this relationship can be dangerous because it can trigger certain interventions by corrupt public officials, which can severely damage the economy of a country, such as the creation of monopolies or fraudulent payments. Corruption often translates to the health sector because of how the health system is built; a lot is at stake with people willing to give money in case of life and death, and there are a lot of power politics that follow. The health system is usually one of the initial institutions that gets established and has a large capital flow, involving expensive machinery, goods, and technologies, which creates spaces to infiltrate and hide corrupt practices. Especially in African states, which were highly deprived and impoverished of vaccines and appropriate medical services for some of the deadliest disease outbreaks like cholera. This historical neglect of the health system, which makes the backbone of a country, was never given importance; this, therefore, created spaces for corrupt health professionals and government servants to serve their personal interests in forms of bribery, goods procurement fraud, and petty corruption. Boateng-Ade argues that Ghana’s present crisis in its healthcare system is the consequence of the systemic corruption embedded in the colonial structure, which limited access to quality care for Ghanaian citizens. This inequality culminated in initially having limited resources and funds to serve the demands of the people. There were cases of unregulated medical practices, a shortage of basic drugs, and the persistence of non-ethical medical practices. This provided a strong ground for corrupt behaviour, including acts of bribery, unequal access to services, and the creation of methods of exploitation.

However, tracing one of the crucial reasons for the failing institutions in African states, most importantly Ghana, is the application of ‘skipping straight to Weber’, which perfectly summarises how Ghana, immediately after independence in 1957, pushed a colonial-style, tax-funded public health system even before dismantling the colonial dual system of healthcare institutions developed during imperial rule. This made the initial foundation of the healthcare structure weak, which eventually led to a systematically dysfunctional institution.

Conclusion

From a broader IR perspective, this challenges dominant liberal assumptions that development depends primarily on domestic political will, institutional design, or policy reform. Instead, post-colonial institutional failure must be situated within global power relations, historical hierarchies, and structural dependencies. Corruption becomes not merely a national problem, but a transnational legacy of imperial governance and uneven global development.

Ultimately, Ghana’s healthcare system illustrates a broader international insight that institutions are not neutral, and development is not linear. Post-colonial states operate within a world system shaped by historical domination and structural inequality. Corruption, therefore, is not simply a failure of morality or leadership, but a symptom of deeper institutional pathologies produced by colonialism and sustained by global asymmetries of power. Understanding corruption through this lens shifts responsibility from individual states to the international structures that continue to shape their developmental possibilities.