5 - Maternal Healthcare and Health Policy Planning in Tanzania, 1961–1970s
Africa Development,
Vol. 49 No. 2 (2024): Africa Development
Abstract
The period immediately after independence in Tanzania was marked by intense planning for the country’s development. Part of this planning involved the healthcare system and was aimed at addressing the grave dangers posed by life-threatening diseases. Improvements in healthcare included the expansion of medical facilities and staff. The government identified maternal health as vital in revamping public health. It understood that the well-being of mothers and children was fundamental for the prosperity of the newly founded state. The focus, however, was on rudimentary health provisions. This article examines health policy planning in Tanzania immediately after independence. Using examples from maternal health, it argues that healthcare planning after independence was still largely shaped by the measures developed under colonial rule despite the optimism about a sovereign future. This was mainly because the problems and plans that had arisen during colonialism remained in existence after independence. The article uses archival, oral and secondary sources to show how attempts to shift health policies were hindered by poor planning, lack of funds, inadequate staff, gender relations and the choice between healthcare and other needs. It examines how the newly independent government negotiated the quest for better healthcare, especially maternal health.
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- Achola M.A., 2000, Preventive Health and Colonial African Urban Policies in Nairobi, African Urban Quarterly. Nairobi: University of Nairobi.
- Achola, M.A., 2005, Public Health Policy in an Urban Setting: The Case of Maternal and Child Welfare in the First Ten Years of Moi’s Rule’, Proceedings of African Health and Illness Conference at the University of Texas in Austin, USA. Nairobi: University of Nairobi.
- Achola M.A., 2006, Public Health Policy in Kenya: The Case of Nairobi Maternal and Child Health, in Falola, T. and Heaton, M. eds., Endangered Bodies: Women, Children and Health in Africa. Trenton, NJ: Africa World Press, pp. 237–248. African Institute for Economic Development and Planning (IDEP), 1968, United Republic of Tanganyika and Zanzibar: First Five-Year Plan for Economic and Social Development, 1st July 1964 to 30th June 1969, Vol 1. Dar es Salaam: Government Printer. https://repository.uneca.org/ds2/stream/#/documents/edc7a7ff-51f3-5725-bc32-beb3d345a89e/page/1
- Anderson, J., 1970, The Struggle for the School: The Interaction of Missionary, Colonial Government and the Nationalist Enterprise in the Development of Formal Education in Kenya. Nairobi: Longman.
- Aravacik, E.D., 2018, Social Policy and the Welfare State, in Açıkgöz, B., Public and Economic Finance, Intech Open. DOI: 10.5772/intechopen.82372.
- Ayoade, J.A.A., 1988, State Without Citizen: An Emerging African Phenomenon, in Rothchild, D. and Chazan, N., eds. The Precarious Balance: The State and Society in Africa. New York: Routledge, pp. 100–118.
- Bech, M.M, Lawi, Y.Q, Massay D.A. and Rekdal O.B., 2013, Changing Policies and Their Influence on Government Health Workers in Tanzania, 1967–2009: Perspectives from Rural Mbulu District, The International Journal of African Historical Studies, Vol. 46, No. 1, pp. 61–103.
- Beck, A., 1970, A History of the British Medical Administration of East Africa, 1900–1950. Cambridge, MA: Harvard University Press.
- Bruchhausen, W., 2003, Practising Hygiene and Fighting the Natives Diseases: Public and Child Health in German East Africa and Tanganyika Territory, 1900–1960, DYNAMIS, Vol. 23, pp. 85–113.
- Budd, H.L., 1978, Mtu Ni Afya (‘Man is Health’): Tanzania’s Health Campaign.
- Washington DC: Agency for International Development.
- Clyde, D., 1962, History of Medical Services in Tanganyika. Dar es Salaam: Government Press.
- Crozier, A., 2007, Practising Colonial Medicine: The Colonial Medical Service in British East Africa. London: Bloomsbury Publishing Plc.
- Davin, A., 1978, Imperialism and Motherhood. History Workshop, Spring, No. 5,
- pp. 9–65.
- Dreier, M., 2015, Health, Welfare and Development in Rural Africa: Catholic Medical Mission and Configuration of Development in Ulanga, Tanzania, 1920–1970. PhD dissertation: University of Basel.
- Etten, G.M.V., 1976, Rural Health Development in Tanzania. Assen: Van Gorcum & Comp. B.V.
- Geiger, S., 1997, TANU Women: Gender and Culture in the Making of Tanganyikan Nationalism, 1955-1965, Portsmouth: Heinemann.
- Giblin, J.L., 1996, The Precolonial Politics of Disease Control In the Lowlands of North-eastern Tanzania, in Maddox, G., Giblin, J. and Kimambo, I., eds. Custodians of the Land Ecology & Culture in the History of Tanzania. London: James Currey.
- Gish, O., 1975, The Way Forward, Journal of World Health 6. https://iris.who.int/ bitstream/handle/10665/272473/WH-1975-Apr-p8-13-eng.pdf?sequence=1
- Gish, O. and Walker, G., 1978, Alternative Forms of Transport and their Use in the Health Sector of Developing Countries, International Journal of Health Services, Vol. 8, No. 4, pp. 633–651.
- Gre n, A., 2007, An Introduction to Health Planning for Developing Health Systems.
- Oxford: Oxford University Press.
- Hart, Dr., 1978, MCH Nutrition: Tackling the Malnutrition Problem in the Ministry of Health, Lishe: Tanzania Food and Nutrition Journal, Vol. 2, No. 4.
- Hunt, N.R., 1988, ‘Le Bébé En Brousse’: European Women, African Birth Spacing and Colonial Intervention in Breast Feeding in the Belgian Congo, The International Journal of African Historical Studies, Vol. 21, No. 3, pp. 401–32. Illife, J., 1998, East African Doctors: A History of the Modern Profession. Cambridge: Cambridge University Press.
- Jennings, M., 2016, Cooperation and Competition: Missions, the Colonial State and Constructing a Healthy System in Colonial Tanganyika, in Greenwood, A. ed., Beyond the State: The Colonial Medical Service in British Africa. Manchester: Manchester University Press pp. 153–73.
- Kahama, G., Maliyamkono T.L. and Wells, S. 1986, The Challenge for Tanzania’s Economy. London: James Currey Ltd.
- Kanogo, T., 2005, African Womanhood in Colonial Kenya 1900–50. Oxford: James Currey Ltd.
- Keita, M., 2007, A Political Economy of Healthcare in Senegal. Leiden: Koninklijke Brill NV.
- Kimani, V., 2015, The Transformation of Circumcision and Masculinity Among the Agikuyu of Kiambu, 1945–2008. Master’s thesis: Kenyatta University.
- Kithinji, M.W., 2012, An Imperial Enterprise: The Making And Breaking of the University of East Africa, 1949–1969, Canadian Journal of African Studies / Revue Canadienne des Études Africaines, Vol. 46, No. 2, pp. 195–214.
- Lindner, U., 2014, The Transfer of European Social Policy Concepts to Tropical Africa, 1900–50: The Example of Maternal and Child Welfare, Journal of Global History, Vol. 9, No. 2, pp. 208–31. DOI:10.1017/S1740022814000047.
- Lynn, T.M., 2003, Politics of the Womb: Women, Reproduction, and the State in Kenya, Oakland, CA: University of California Press.
- Machado, R., 1950, Hatutakumbali Wanaume Clinic, ZUHRA Newspaper, 23 September, p. 10.
- Macrotrends, n.d. Tanzania Infant Mortality Rate 1950–2024. https://www. macrotrends.net/countries/TZA/tanzania/infant-mortality-rate Accessed 25.8.2023.
- Malowany, M., 1997, Medical Pluralism: Disease, Health and Healing on the Coast of Kenya, 1840–1940. PhD thesis: McGill University.
- Malpass, P., 2005, Housing and the Welfare State: The Development of Housing Policy in Britain, New York: Palgrave Macmillan.
- Mandela, N., 1994, Long Walk to Freedom: The Autobiography of Nelson Mandela.
- London: Abacus.
- Masebo, O., 2010, Society, State, and Infant Welfare: Negotiating Medical Interventions in Colonial Tanzania, 1920–1950. PhD thesis: University of Minnesota.
- Mbilinyi, M.J., 1979, African Education During British Colonial Period, 1919–1961, in Kaniki, M.H.Y. ed., 1980, Tanzania Under Colonial Rule, Harlow: Longman, p. viii. Meredeth, T., 1977, The Impact of Colonialism on Health and Health Services in
- Tanzania, International Journal of Health Services, Vol. 7, No. 1, pp. 8–30.
References
Achola M.A., 2000, Preventive Health and Colonial African Urban Policies in Nairobi, African Urban Quarterly. Nairobi: University of Nairobi.
Achola, M.A., 2005, Public Health Policy in an Urban Setting: The Case of Maternal and Child Welfare in the First Ten Years of Moi’s Rule’, Proceedings of African Health and Illness Conference at the University of Texas in Austin, USA. Nairobi: University of Nairobi.
Achola M.A., 2006, Public Health Policy in Kenya: The Case of Nairobi Maternal and Child Health, in Falola, T. and Heaton, M. eds., Endangered Bodies: Women, Children and Health in Africa. Trenton, NJ: Africa World Press, pp. 237–248. African Institute for Economic Development and Planning (IDEP), 1968, United Republic of Tanganyika and Zanzibar: First Five-Year Plan for Economic and Social Development, 1st July 1964 to 30th June 1969, Vol 1. Dar es Salaam: Government Printer. https://repository.uneca.org/ds2/stream/#/documents/edc7a7ff-51f3-5725-bc32-beb3d345a89e/page/1
Anderson, J., 1970, The Struggle for the School: The Interaction of Missionary, Colonial Government and the Nationalist Enterprise in the Development of Formal Education in Kenya. Nairobi: Longman.
Aravacik, E.D., 2018, Social Policy and the Welfare State, in Açıkgöz, B., Public and Economic Finance, Intech Open. DOI: 10.5772/intechopen.82372.
Ayoade, J.A.A., 1988, State Without Citizen: An Emerging African Phenomenon, in Rothchild, D. and Chazan, N., eds. The Precarious Balance: The State and Society in Africa. New York: Routledge, pp. 100–118.
Bech, M.M, Lawi, Y.Q, Massay D.A. and Rekdal O.B., 2013, Changing Policies and Their Influence on Government Health Workers in Tanzania, 1967–2009: Perspectives from Rural Mbulu District, The International Journal of African Historical Studies, Vol. 46, No. 1, pp. 61–103.
Beck, A., 1970, A History of the British Medical Administration of East Africa, 1900–1950. Cambridge, MA: Harvard University Press.
Bruchhausen, W., 2003, Practising Hygiene and Fighting the Natives Diseases: Public and Child Health in German East Africa and Tanganyika Territory, 1900–1960, DYNAMIS, Vol. 23, pp. 85–113.
Budd, H.L., 1978, Mtu Ni Afya (‘Man is Health’): Tanzania’s Health Campaign.
Washington DC: Agency for International Development.
Clyde, D., 1962, History of Medical Services in Tanganyika. Dar es Salaam: Government Press.
Crozier, A., 2007, Practising Colonial Medicine: The Colonial Medical Service in British East Africa. London: Bloomsbury Publishing Plc.
Davin, A., 1978, Imperialism and Motherhood. History Workshop, Spring, No. 5,
pp. 9–65.
Dreier, M., 2015, Health, Welfare and Development in Rural Africa: Catholic Medical Mission and Configuration of Development in Ulanga, Tanzania, 1920–1970. PhD dissertation: University of Basel.
Etten, G.M.V., 1976, Rural Health Development in Tanzania. Assen: Van Gorcum & Comp. B.V.
Geiger, S., 1997, TANU Women: Gender and Culture in the Making of Tanganyikan Nationalism, 1955-1965, Portsmouth: Heinemann.
Giblin, J.L., 1996, The Precolonial Politics of Disease Control In the Lowlands of North-eastern Tanzania, in Maddox, G., Giblin, J. and Kimambo, I., eds. Custodians of the Land Ecology & Culture in the History of Tanzania. London: James Currey.
Gish, O., 1975, The Way Forward, Journal of World Health 6. https://iris.who.int/ bitstream/handle/10665/272473/WH-1975-Apr-p8-13-eng.pdf?sequence=1
Gish, O. and Walker, G., 1978, Alternative Forms of Transport and their Use in the Health Sector of Developing Countries, International Journal of Health Services, Vol. 8, No. 4, pp. 633–651.
Gre n, A., 2007, An Introduction to Health Planning for Developing Health Systems.
Oxford: Oxford University Press.
Hart, Dr., 1978, MCH Nutrition: Tackling the Malnutrition Problem in the Ministry of Health, Lishe: Tanzania Food and Nutrition Journal, Vol. 2, No. 4.
Hunt, N.R., 1988, ‘Le Bébé En Brousse’: European Women, African Birth Spacing and Colonial Intervention in Breast Feeding in the Belgian Congo, The International Journal of African Historical Studies, Vol. 21, No. 3, pp. 401–32. Illife, J., 1998, East African Doctors: A History of the Modern Profession. Cambridge: Cambridge University Press.
Jennings, M., 2016, Cooperation and Competition: Missions, the Colonial State and Constructing a Healthy System in Colonial Tanganyika, in Greenwood, A. ed., Beyond the State: The Colonial Medical Service in British Africa. Manchester: Manchester University Press pp. 153–73.
Kahama, G., Maliyamkono T.L. and Wells, S. 1986, The Challenge for Tanzania’s Economy. London: James Currey Ltd.
Kanogo, T., 2005, African Womanhood in Colonial Kenya 1900–50. Oxford: James Currey Ltd.
Keita, M., 2007, A Political Economy of Healthcare in Senegal. Leiden: Koninklijke Brill NV.
Kimani, V., 2015, The Transformation of Circumcision and Masculinity Among the Agikuyu of Kiambu, 1945–2008. Master’s thesis: Kenyatta University.
Kithinji, M.W., 2012, An Imperial Enterprise: The Making And Breaking of the University of East Africa, 1949–1969, Canadian Journal of African Studies / Revue Canadienne des Études Africaines, Vol. 46, No. 2, pp. 195–214.
Lindner, U., 2014, The Transfer of European Social Policy Concepts to Tropical Africa, 1900–50: The Example of Maternal and Child Welfare, Journal of Global History, Vol. 9, No. 2, pp. 208–31. DOI:10.1017/S1740022814000047.
Lynn, T.M., 2003, Politics of the Womb: Women, Reproduction, and the State in Kenya, Oakland, CA: University of California Press.
Machado, R., 1950, Hatutakumbali Wanaume Clinic, ZUHRA Newspaper, 23 September, p. 10.
Macrotrends, n.d. Tanzania Infant Mortality Rate 1950–2024. https://www. macrotrends.net/countries/TZA/tanzania/infant-mortality-rate Accessed 25.8.2023.
Malowany, M., 1997, Medical Pluralism: Disease, Health and Healing on the Coast of Kenya, 1840–1940. PhD thesis: McGill University.
Malpass, P., 2005, Housing and the Welfare State: The Development of Housing Policy in Britain, New York: Palgrave Macmillan.
Mandela, N., 1994, Long Walk to Freedom: The Autobiography of Nelson Mandela.
London: Abacus.
Masebo, O., 2010, Society, State, and Infant Welfare: Negotiating Medical Interventions in Colonial Tanzania, 1920–1950. PhD thesis: University of Minnesota.
Mbilinyi, M.J., 1979, African Education During British Colonial Period, 1919–1961, in Kaniki, M.H.Y. ed., 1980, Tanzania Under Colonial Rule, Harlow: Longman, p. viii. Meredeth, T., 1977, The Impact of Colonialism on Health and Health Services in
Tanzania, International Journal of Health Services, Vol. 7, No. 1, pp. 8–30.