Marcel Dreier: Health Care, Welfare, and Development in Rural Africa: Catholic health services in Ifakara/Tanzania in the 20th century

PhD-project, Department of History, University of Basel

Rural health care systems in many parts of Africa developed from mission medical services. In the course of the 20th century the politics and practice of health service provision were constantly reconfigured in relation to changes in economies, cultures and science. To understand these processes detailed historical accounts integrating colonial and post-independence eras as well as social history and cultural and discursive approaches are very much needed.

Specific objectives

This study describes service provision and use in  Ulanga & Kilombero districts in south-central Tanzania, where Swiss Missions established extensive health services. The study describes historical actors and analyses the changing character of health care and its rationales. Furthermore the case studies shed light on the long history of development practices.


From the level of institutions and their immediate environment I look at the larger forces that shaped how health systems worked, how they were understood and represented. I use previously unused archival documentation and oral testimony collected in Africa and Europe.

First Results

Changes in health services provision rarely resulted from straightforward program implementation but depended on configurations of power and their negotiation on local, national and international levels as well as on practices and traditions of specifc health institutions.


Supervisor: Prof. Patrick Harries

Swiss National Science Foundation
Swiss Network for International Studies
Freiwillige Akademische Gesellschaft Basel FAG

Prof. Y. Lawi & F. Kaijage, University of Dar es Salaam
Prof. K.A. Senah, Department of Sociology, University of Ghana

Duration: April 2008 ‐ December 2011

Download Poster: History of Health and Health Care Delivery Systems in Africa (2012)

Research Group: History of Health and Health Care Delivery Systems in Africa

Keywords: Tanzania, Ghana, history of health care, medicine, development, mission

Graduate School of History Basel
Research Group at Department of History, University of Basel