Questionable structure reform

Luise Steinwachs:
Die Herstellung sozialer Sicherheit in Tansania. Prozesse sozialer Transformation und die Entstehung neuer Handlungsräume [Establishing social security in Tanzania. Processes of social transformation and the emergence of new spheres of activity].
Lit Verlag, Berlin 2006, 284 p.,
25.90 Euro, ISBN 3-8258-8293-4

Tanzania wants to reform its social security system to make it more financially sustainable – also as a response to pressure from donors. This study by Luise Steinwachs, which was originally a doctoral thesis, investigates what the change will mean for the local population. It soon becomes clear that the reforms are a double-edged sword. On the one hand, the standard of healthcare should improve, but on the other, many of the poor will be unable to pay the “user fees” charged for health services. Accordingly, family networks will become more important, along with new forms of social self-organisation. Women are a driving force in setting up such systems.

The book is interestingly written and allows numerous interview partners, both men and women, to have their say. When reading, it soon becomes clear that once again structural adjustment is missing its target. It fails to generate a stable healthcare service which is affordable to all in Tanzania. Instead it downright fuels the formation of informal structures.

Frank Bliss

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