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The Construction Industry in Africa is noted for high project failure partly emerging from the adoption of inappropriate procurement strategies. The above challenges amongst others have resulted in European and Asian countries adopting the integrated procurement strategy. In Ghana, over 90% of projects are procured using the traditional design bid build procurement strategy (DBB). This book reviews literature on the procurement systems adopted in Ghana, the emergence of the Design and Build (DB) procurement system in Europe, its merits and demerits in comparison to the traditional DBB procurement system adopted in Africa. Based on ethnographic field studies, the book reviews the readiness of the industry in Africa to embrace DB system as an alternative to the DBB for future projects. The challenge however stems from the fact that over 90% of projects executed in Africa are directly financed by the central government. The question now is: how ready is the major developmental player in adopting DB in Africa?