5 - Maternal Healthcare and Health Policy Planning in Tanzania, 1961–1970s
Afrique et développement,
Vol. 49 No 2 (2024): Afrique et développement
Résumé
Immédiatement après son indépendance, la Tanzanie a été marquée par une intense réorganisation du pays vers un avenir meilleur. Ce changement concernait en partie le système de santé et visait à répondre aux graves dangers posés par les maladies mortelles. Pour améliorer la santé, l'expansion des établissements sanitaires et celle du personnel étaient incluses. Le gouvernement a déterminé la santé maternelle comme essentiel pour la réorganisation de la santé publique. Il avait compris que le bien-être des mères et des enfants était fondamental pour la prospérité de l'État nouvellement fondé. Toutefois, l'accent a été mis sur des dispositions sanitaires rudimentaires. Cet article étudie la planification de la politique de santé en Tanzanie immédiatement après l'indépendance. À l'aide d'exemples tirés de la santé maternelle, il soutient que, malgré l'optimisme quant à un avenir souverain, la planification des soins médicaux après l'indépendance a encore été largement façonnée par les mesures développées sous le régime colonial à cause des problèmes et projets qui avaient vu le jour pendant la période coloniale et qui se sont poursuivis après l'indépendance. L'article s'appuie sur des archives, des sources orales et secondaires pour montrer comment les tentatives de réorientation des politiques de santé ont été entravées par une mauvaise planification, un manque de fonds, un personnel non qualifié, des relations hommes-femmes et le choix entre la santé et d'autres besoins. Il examine comment le nouveau gouvernement indépendant négociait à la recherche de meilleurs systèmes de santé, en particulier la santé maternelle.
Mots-clés
Télécharger la référence bibliographique
Endnote/Zotero/Mendeley (RIS)BibTeX
- 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.
Les références
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.