Abstract In Burkina Faso, political turmoil, escalating insecurity and a looming pandemic challenge the population's trust in the state. This article contributes to the debates about state–citizen relationships in fragile countries by connecting local health-seeking practices with the global trends of datafication and a strong focus on the fight against malaria in this part of Africa. Drawing on long-term research engagement in Burkina Faso, I examine the health-seeking practices of rural citizens and look into diagnostic routines and reporting in two rural dispensaries. I show how the routinization of diagnostic procedures combined with a strong national and global political focus on the fight against malaria create what I term a ‘supply–demand nexus’ in which rural citizens selectively ask for the health services that they know the system can supply. I argue that the routinized diagnostic practices that mainly focus on malaria serve as a ‘technology of invisibility’ by not capturing other important diseases among the rural population. Finally, I ask whether the limited healthcare services in the current context of political insecurity, instability and a global pandemic spur a process of further fragilization of the social contract between rural citizens and the state.

中文翻译：

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加速脆弱性：探索布基纳法索农村卫生设施的供需关系

摘要 在布基纳法索，政治动荡、不断升级的不安全感和迫在眉睫的流行病挑战了人们对国家的信任。本文将当地寻求健康的做法与数据化的全球趋势联系起来，并重点关注非洲这一地区抗击疟疾的斗争，从而为脆弱国家关于国家-公民关系的辩论做出贡献。利用在布基纳法索的长期研究参与，我检查了农村居民的求医行为，并研究了两个农村药房的诊断程序和报告。我展示了诊断程序的常规化与国家和全球对抗击疟疾的强烈政治关注相结合如何创建我称之为“供需关系”的农村公民有选择地要求他们知道该系统可以提供的卫生服务. 我认为，主要针对疟疾的常规诊断实践是一种“隐形技术”，因为它没有在农村人口中发现其他重要疾病。最后，我问，在当前政治不安全、不稳定和全球大流行的背景下，有限的医疗服务是否会刺激农村公民与国家之间的社会契约进一步脆弱化的过程。我认为，主要针对疟疾的常规诊断实践是一种“隐形技术”，因为它没有在农村人口中发现其他重要疾病。最后，我问，在当前政治不安全、不稳定和全球大流行的背景下，有限的医疗服务是否会刺激农村公民与国家之间的社会契约进一步脆弱化的过程。我认为，主要针对疟疾的常规诊断实践是一种“隐形技术”，因为它没有在农村人口中发现其他重要疾病。最后，我问在当前政治不安全、不稳定和全球大流行的背景下，有限的医疗服务是否会刺激农村公民与国家之间的社会契约进一步脆弱化的过程。