Universität zu Köln

Kimani, Veronica ORCID: 0000-0003-2712-7848 (2026). Creating Health Futures: Maternal Health Policy, Planning, and the Making of Postcolonial Tanzania, 1961–1980. PhD thesis, Universität zu Köln.

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Abstract

This thesis examines the development of maternal health policy planning in Tanzania between 1961 and 1980 within the broader context of postcolonial nation-building. The period from 1961 to 1980 marked Tanzania’s transition from colonial rule to self-governance. Future-making and planning dominated the making of the newly independent state of Tanzania under the leadership of President Julius Kambarage Nyerere and his party, the Tanganyika African National Union (TANU). After independence, Nyerere underscored the urgent need to combat ignorance, poverty, and disease. According to Nyerere, these three enemies were detrimental not just to the health of the people but also to Tanzania’s national development and future. Yet, the legacy of colonialism continued to shape the health sector, where welfare and medical services had historically been marginal to colonial agendas and often delegated to Christian missionaries. The rural areas were conspicuously neglected in the national health plans and provisions. The new post-independence government faced the dual challenge of inheriting an underdeveloped colonial health infrastructure while seeking to fulfil the nationalist aspirations of equitable service provision. Focusing on maternal health, this study examines how the Tanzanian state envisioned, planned, and implemented health policies during the first two decades of independence. It explores the impact of Ujamaa and broader socio-economic strategies on healthcare delivery, as well as the roles of TANU members, experts, and missionaries. The study also focuses on the instrumental role of transnational actors, specifically Switzerland and China, in health-policy planning in Tanzania. The analysis is grounded in three theoretical frameworks: the travelling theory, which highlights the transnational movement and adaptation of ideas—in this case, concepts of health; political economy, which foregrounds the state’s role in structuring health systems; and the postcolonial theory of hybridity, which critiques the imposition of external models without adequate integration of local knowledge and practices. Methodologically, the study draws on archival research, oral histories, and secondary sources. The collected data enabled an investigation into how national-level policies, primarily formulated in urban areas, were reflected in and implemented at the local level in the rural Kilombero Valley. Ultimately, the study revealed how health-policy planning in postcolonial Tanzania followed colonial patterns. The challenges faced by health workers and facilities necessitated the mobilisation of resources to build health structures through Ujamaa, as well as assistance from international cooperation. The study also shows the struggle of women in navigating maternal health concepts and national policies, as shown in aspects such as maternity leave and family planning. Despite the notable efforts that Tanzania demonstrated in improving health, this study shows how health plans often failed, worsened by problematic infrastructure, and an ambivalent rural-urban divide that influenced the health system, even during periods of relative economic success and gradual service expansion in the 1960s and early 1970s, and the ultimate decline in the 1980s.

Item Type:	Thesis (PhD thesis)
Translated title:	Title Language Eine gesunde Zukunft gestalten: Müttergesundheitspolitik, Planung und die Entstehung des postkolonialen Tansania, 1961–1980 German
Translated abstract:	Abstract Language Diese Arbeit untersucht die Entwicklung der Gesundheitspolitik für Mütter in Tansania zwischen 1961 und 1980 im breiteren Kontext des postkolonialen Staatsaufbaus. Der Zeitraum von 1961 bis 1980 war geprägt vom Übergang Tansanias von der Kolonialherrschaft zur Selbstverwaltung. Die Gestaltung der Zukunft und die Planung dominierten den Aufbau des neuen unabhängigen Staates Tansania unter der Führung von Präsident Julius Kambarage Nyerere und seiner Partei, der Tanganyika African National Union (TANU). Nach der Unabhängigkeit betonte Nyerere die dringende Notwendigkeit, Unwissenheit, Armut und Krankheit zu bekämpfen. Seiner Meinung nach waren diese drei Feinde nicht nur schädlich für die Gesundheit der Menschen, sondern auch für die nationale Entwicklung und Zukunft Tansanias. Dennoch prägte das Erbe des Kolonialismus weiterhin den Gesundheitssektor, in dem Sozial- und Gesundheitsdienste historisch gesehen nur eine untergeordnete Rolle in der Kolonialpolitik spielten und oft christlichen Missionaren übertragen wurden. Die ländlichen Gebiete wurden in den nationalen Gesundheitsplänen und -vorschriften auffällig vernachlässigt. Die neue Regierung nach der Unabhängigkeit stand vor der doppelten Herausforderung, eine unterentwickelte koloniale Gesundheitsinfrastruktur zu übernehmen und gleichzeitig die nationalistischen Bestrebungen nach einer gerechten Versorgung zu erfüllen. Mit Schwerpunkt auf der Gesundheit von Müttern untersucht diese Studie, wie der tansanische Staat in den ersten zwei Jahrzehnten nach der Unabhängigkeit Gesundheitspolitik konzipierte, plante und umsetzte. Sie untersucht die Auswirkungen von Ujamaa und umfassenderen sozioökonomischen Strategien auf die Gesundheitsversorgung sowie German
Creators:	Creators Email ORCID ORCID Put Code Kimani, Veronica vkimani@uni-koeln.de https://orcid.org/0000-0003-2712-7848 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-798265
Date:	2026
Language:	English
Faculty:	Faculty of Arts and Humanities
Divisions:	Ehemalige Fakultäten, Institute, Seminare > Erziehungswissenschaftliche Fakultät > Seminar für Geschichte und für Philosophie
Subjects:	Philosophy Social sciences Geography and history
Uncontrolled Keywords:	Keywords Language Tanzania, Planning, Futures, maternal health, policy, Traditional medicine, Bio medicine, development, Ujamaa English
Date of oral exam:	2 December 2025
Referee:	Name Academic Title Lindner, Ulrike Professor
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/79826