The central argument of this paper is that health care delivery systems, like any other social institution, are shaped by various forces relating to their respective societal context. Essentially, therefore, imbalances can be explained through historical, cultural, social, economic and political forces. In this paper only historical circumstances, prevailing ideology, power and income distribution are considered. These forces vary from country to country in terms of their nature and impact on the health care system. The discussion assumes that rural-urban disparities in the modern health care services in Zambia occur as a logical outcome of a historical process in relation to die forces referred to. A consideration of the introduction of allopathic medicine in Zambia by missionaries, and the impact of the mining industry and the government on the distribution of health care services, is, therefore, of critical importance.
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