This article explores the African Mental Health Action Group (AMHAG), one of the earliest examples of the World Health Organization’s (WHO) attempts to promote ‘ownership’ over development through the South–South cooperation envisaged in Technical Cooperation in Developing Countries. Formed in 1978, the AMHAG was intended to guide national and regional policy on mental health, while also fostering national and collective self-reliance. For a short period, between the late 1970s and the early 1990s, it was central to the WHO’s strategy for promoting policies of mental health in primary healthcare in Africa. It was a largely ineffective tool, with national governments having different opinions on the value of mental health, and poor coordination between AMHAG countries. Approaching the AMHAG as a regional project and transnational network, however, the article provides explores the importance of regions and regionalism in international health cooperation, as well as the inequities of participation in health development. Drawing on WHO archival material spanning over twenty countries and two national liberation movements, it argues that participating countries were differently positioned not only to navigate relationships between countries, but also to contend with the shifting landscape of international assistance, as well as – for some – contexts of war, violence and political and economic instability. The article not only serves as a case study of power imbalances in a failed development initiative, but also sheds light on the WHO’s engagement with mental health during a period that historians of psychiatry in Africa have tended to overlook.

Though male doctors gained prominence at the bedsides of pregnant mothers in nineteenth-century Europe, the clinical training they received in medical academies remained cursory. In France, to supplement the medical faculties, the government set up schools for both health officers and midwives which were meant to teach practical obstetrics. This paper focusses on the city of Arras, where these two groups of students competed for the limited numbers of pregnant patients on which to practice their future professions. Like many in their field, two prominent instructors in Arras at each end of the century promoted male obstetrical education over female, arguing that practical education for health officers would lead to safer births for mothers and infants. By the 1870s, the obstetrics instructor adopted germ theory, tying improved hygiene and thus mortality rates to male students’ access to hospitalised patients. Despite their arguments, in Arras, the male students never gained priority in clinical obstetrical training, which midwifery students kept. To keep male students out of maternity wards, local administrators used fears that gender mixing would lead to immoral acts or thoughts. In doing so, they protected the traditional system of midwifery rather than invest in more costly male medical education. Championing midwifery students’ rights to the spaces and bodies needed for their education, however, delayed adoption of hygiene and antiseptic practices that led to lower maternal mortality. Unable to adapt to changing requirements by the state, the medical school closed in 1883, while the midwifery programme thrived until the 1960s.