ABSTRACT

In Tanzanian health care, the public health sector reflects this low-income economy's acute fiscal pressure, and also society's gendered social hierarchies of employment, training, income and status. The current levels of exclusion and poor quality of care in Tanzanian health care are very serious, and the challenge involved in moving towards universal health coverage is enormous. This chapter argues that planning for improvement is a process of institutional (re)design, by which one mean the conscious encouragement of institutions that display 'goodness of fit' with "some larger objectives than those narrow ones embodied in the internal goals of the institution and its immediate environment. Tanzania continues to suffer a huge burden of mortality and morbidity related to childbearing. Pharmaceutical manufacturing has a long history in Sub-Saharan Africa, and Tanzanian manufacturing began in the 1960s and 1970s, mainly by public sector firms.