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.
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.
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.