In 1922, the southern twenty-six counties of Ireland secured political independence from Britain with the foundation of the Irish Free State. The new state was no blank canvas, of course, as it proceeded to govern based on the legacy, infrastructure and legislation of hundreds of years of British rule. Nowhere was this more apparent than in the arena of public health: pre-1922 legislation relating to the medical treatment of the poor and destitute, compulsory vaccination, the registration and notification of births and deaths and the role of local government in public health were to provide the framework of the Irish Free State's approach to health. The Ireland of the early twentieth century was also focused on controlling infectious diseases, regulating midwifery (lest the country became ‘the dumping ground for the inepts [sic] of Great Britain’), and reducing maternal and infant mortality.

Ireland was a predominantly rural, agrarian and traditional society, dominated by Roman Catholicism with a highly conservative moral climate. Irish public debate continued throughout the twentieth century to display suspicion of the state and central government. The Roman Catholic hierarchy was often perceived, and indeed portrayed itself as, a counterweight to the perils of undue state control or interference.