Hospital side hustles: Funding conundrums and perverse incentives in Tanzania's publicly-funded health sector.

Following three decades of international financial institutions implementing austerity measures in sub-Saharan Africa, many health systems remain chronically underfinanced. During this period, countries like Tanzania have moved from a post-independence vision of a strong social sector providing free care for citizens, to a model of increased privatization of public health facilities, shifting the burden of self-financing to individual health facilities and the constituents they serve. Drawing on longitudinal ethnographic research and document analysis undertaken between 2008 and 2017 within three publicly-funded hospitals in north-central Tanzania, this article examines the actions and perspectives of administrators to explore how novel shifts towards semi-privatization of public facilities are perceived as taken-for-granted solutions to funding shortfalls.

International clinical volunteering in Tanzania: A postcolonial analysis of a Global Health business.

This article traces how scarcities characteristic of health systems in low-income countries (LICs), and increasing popular interest in Global Health, have inadvertently contributed to the popularisation of a specific Global Health business: international clinical volunteering through private volunteer placement organisations (VPOs). VPOs market neglected health facilities as sites where foreigners can 'make a difference', regardless of their skill set. Drawing on online investigation and ethnographic research in Tanzania over four field seasons from 2011 to 2015, including qualitative interviews with 41 foreign volunteers and 90 Tanzanian health workers, this article offers a postcolonial analysis of VPO marketing and volunteer action in health facilities of LICs.

Mediating abundance and scarcity: implementing an HIV/AIDS-targeted project within a government hospital in Tanzania.

While free antiretroviral therapy (ART) in Tanzania has undeniably increased accessibility of services, the effects of ART programs as they are brought into existing health facilities are more ambiguous. As transnational nongovernmental organizations (NGOs) establish clinics within government hospitals, we see a telling example of how NGOs are providing services from within the state. The conditions of NGO-operated clinics within government health facilities act as a daily reminder of the failures of the government to provide health workers with that to which they feel entitled: adequate pay, access to sophisticated technology, upgraded training, extra-duty allowances, and a professional working environment.