We chart and assess the scope and utilisation of state-supplied hospital infrastructure in British Africa, c. 1900–60. Using archival sources, we examine the heterogeneity in colonial administrations’ investment into curative healthcare provision across various regions of British Africa. Our research highlights significant disparities in healthcare provision during the colonial period. These disparities were shaped by a range of observable factors, including differences in colonial policies, budgets, investment priorities, and the availability of medical personnel. We test stylised facts about public goods provision derived from previous literature and highlight the importance of understanding the historical context in shaping healthcare systems in Africa today.