Paper short abstract:

In this paper, I explore the pragmatic use – and non-use of primary health care facilities by citizens in rural Burkina Faso and discuss why the relationship between the state and its citizens appears so fragile.

Paper long abstract:

The security situation in the West African region is subject to international concern as it appears increasingly fragile. In Burkina Faso, the situation has been fairly stable over the last two decades, but the conflicts in neighbouring countries also shake the political stability in Burkina. In the project "Fragile Futures: Rural lives in times of conflict", we explore the critical relationship between civil society and state from a village perspective. The relationship to the government health services is the most prominent and critical relationship the rural population has to public institutions. In this paper, I explore the pragmatic use - and non-use - of the primary health care facilities by rural citizens. By careful reading of reports from the health facilities, I also look at the use and non-use of specific diagnoses and discuss how villagers' understand the relationship between the state and its citizens and why this link appears so fragile.