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Working in scarcity: Effects on social interactions and biomedical care in a Tanzanian hospital

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  • Strong, Adrienne E.

Abstract

Based on mixed-methods, ethnographic research in government health facilities conducted in Rukwa, Tanzania over 23 months between 2012 and 2015, this paper explores the social implications of budget shortfalls in the healthcare system at the level of a regional hospital. Budget crises resulted from the late disbursal of funds and the failure of outside donors to meet aid commitments needed to subsidize healthcare at the national level. Healthcare administrators recounted specific donors who pulled out of commitments as a direct result of foreign government austerity measures enacted after the global financial crisis of 2008. In this environment of scarcity, partially due to years of reduced donor funds in the region, regional healthcare administrators circumvented bureaucratic fiscal procedures to ensure the continued functioning of facilities, and healthcare personnel struggled to provide pregnant women with high quality care in times of emergencies. Providers cited low morale and demotivation due to deteriorating physical infrastructure, lack of supplies, and poor relations with the community as key factors inhibiting their ability to care for the women who came to their facilities.

Suggested Citation

  • Strong, Adrienne E., 2017. "Working in scarcity: Effects on social interactions and biomedical care in a Tanzanian hospital," Social Science & Medicine, Elsevier, vol. 187(C), pages 217-224.
    • Handle: RePEc:eee:socmed:v:187:y:2017:i:c:p:217-224
    DOI: 10.1016/j.socscimed.2017.02.010
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    References listed on IDEAS

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    1. Sebastian Edwards, 2014. "Is Tanzania a Success Story? A Long-Term Analysis," NBER Chapters, in: African Successes, Volume I: Government and Institutions, pages 357-432, National Bureau of Economic Research, Inc.
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    Cited by:

    1. McKnight, Jacob & Nzinga, Jacinta & Jepkosgei, Joyline & English, Mike, 2020. "Collective strategies to cope with work related stress among nurses in resource constrained settings: An ethnography of neonatal nursing in Kenya," Social Science & Medicine, Elsevier, vol. 245(C).
    2. Marten, Meredith G. & Sullivan, Noelle, 2020. "Hospital side hustles: Funding conundrums and perverse incentives in Tanzania's publicly-funded health sector," Social Science & Medicine, Elsevier, vol. 244(C).
    3. Smith-Oka, Vania, 2022. "Cutting Women: Unnecessary cesareans as iatrogenesis and obstetric violence," Social Science & Medicine, Elsevier, vol. 296(C).
    4. Vestering, Asra & de Kok, Bregje C. & Browne, Joyce L. & Adu-Bonsaffoh, Kwame, 2021. "Navigating with logics: Care for women with hypertensive disorders of pregnancy in a tertiary hospital in Ghana," Social Science & Medicine, Elsevier, vol. 289(C).

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