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Participation in Social Health Protection: An Anthropological Case Study in Tanzania

English title Participation in Social Health Protection: An Anthropological Case Study in Tanzania
Applicant Obrist Brigit
Number 169476
Funding scheme Project funding (Div. I-III)
Research institution Ethnologisches Seminar Universität Basel
Institution of higher education University of Basel - BS
Main discipline Ethnology
Start/End 01.01.2017 - 31.12.2020
Approved amount 420'016.00
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Keywords (3)

Social health protection; Tanzania; Participation

Lay Summary (German)

Lead
Partizipation - ein machtvolles Schlagwort der Entwicklungspolitik - ist ein Grundprinzip der Ziele für nachhaltige Entwicklung 2015-2030, auch im Bereich der sozialen Gesundheitssicherung. Dabei trifft die Aufforderung, an neuen und durch externe Akteure eingeführten Instrumenten der Gesundheitssicherung zu partizipieren, in Ländern wie Tansania auf organisch vor Ort gewachsene soziale Praxen sozialer Sicherung.
Lay summary
Sozialanthropologinnen und Sozialanthropologen teilen meist die emanzipatorischen und humanitären Anliegen, die durch den Begriff «Partizipation» impliziert werden. Gleichzeitig stehen sie der Art und Weise, wie dieses populäre Schlagwort im heutigen Entwicklungsdiskurs benutzt wird, immer kritischer gegenüber und zeigen die Ambivalenzen, Dilemmata und Paradoxa partizipativer Entwicklungsplanung, -politik und -programme auf. Auch im Handlungsfeld der sozialen Gesundheitssicherung ist Partizipation ins Zentrum des politischen und wissenschaftlichen Interesses gerückt. Aus sozialanthropologischer Sicht gilt es zu untersuchen, wie die Teilnahme in und Teilhabe an unterschiedlichen Formen der Gesundheitssicherung als soziale Praxis umfassendere soziale und materielle Ordnungen konfiguriert bzw. durch diese konfiguriert wird. In Tansania hat Partizipation als entwicklungspolitisches Prinzip eine lange und bewegte Geschichte. Dies spielgelt sich auch in der Aspiration der heutigen Regierung wieder, Tansania in ein Land mit mittlerem Einkommen zu transformieren, in dem die soziale Gesundheitssicherung gewährleistet ist. Mit einer Ethnographie der Partizipation an Gesundheitssicherung als soziale Praxis in Tansania leistet das Forschungsprojekt einen Beitrag an die Entwicklung einer «Anthropologie der Versicherung» und engagiert sich kritisch im Entwicklungsdiskurs zur sozialen Gesundheitssicherung.
Direct link to Lay Summary Last update: 04.12.2016

Lay Summary (English)

Lead
Social protection against staggering health care costs in Tanzania
Lay summary

Participation has become a powerful concept. It circulates around the globe, engages policy makers as well as human rights activists and is a key principle of the Sustainable Development Goals 2015-2030. Anthropologists tend to share the emancipatory and humanitarian concerns implicit in ‘participation’, but they are highly critical of the ways in which 'participation' is used in global development.

This project examines ‘participation’ in the emergent field of ‘social health protection’ created by the ILO, World Bank and the World Health Organization to reach Universal Health Coverage. It encompasses diverse health financing interventions for Low and Middle Income Countries, often implemented through ‘induced participation’ and collective forms of ‘organic participation’. The massive attention given to interventions bears the danger of not only obscuring but perhaps even destroying people’s omnipresent but less visible strife for social participation in family and kin networks and self-organized groups to protect their health and improve their life condition.

Contemporary Tanzania presents a particularly interesting case for studying participation in social health protection in this broader sense. It has long engaged with changing forms of participatory development and the government’s current aspiration to transform Tanzania into a middle-income country with Universal Health Coverage. The project thus aims at demonstrating that participation in diverse forms of social health protection can be conceived as a social practice which configures and is reconfigured by broader societal and material orders. Combining a multi-level analysis with in-depth ethnographic field research the project will explore understudied aspects in current research on induced and organic participation and thus contribute to transforming current development perspectives on social and societal change.
Direct link to Lay Summary Last update: 04.12.2016

Responsible applicant and co-applicants

Employees

Abstract

Over the past decades, ‘participation’ has become a powerful concept of global development. It circulates around the globe and engages policy makers as well as human rights activists. After capturing the imagination of the biggest players in the field, it has attracted massive funding. And as a crucial principle of the Sustainable Development Goals 2015-2030, it can be expected to do so in the future. Anthropologists tend to share the emancipatory and humanitarian concerns implicit in ‘participation’. At the same time, they have become highly critical of the ways in which this popular buzzword is used in contemporary development speak and produce a growing body of empirical evidence about the ambivalences, dilemma and paradoxes created by participatory planning, policies and programs. This project examines ‘participation’ in the emergent field of ‘social health protection’. In order to reach their goal of Universal Health Coverage, the International Labor Office, the World Bank and the World Health organization push social health protection as a key strategy. They come up with diverse measures of public and publicly organized health financing measures for Low and Middle Income Countries, some of which are implemented through ‘induced participation’ and collective forms of ‘organic participation’. The massive attention given to efforts of inducing participation bears the danger of not only obscuring but perhaps even destroying people’s omnipresent but less visible strife for social participation in family and kin networks and self-organized groups to protect their health and improve their life condition.Contemporary Tanzania presents a particularly interesting case for studying participation in social health protection in this broader sense because of her long engagement with changing forms of participatory development and the government’s current aspiration to transform Tanzania into a middle-income country with Universal Health Coverage. The project thus aims at demonstrating that participation in diverse forms of social health protection can be conceived as a social practice which configures and is reconfigured by broader societal and material orders. Combining a multi-level analysis with in-depth ethnographic field research the project will explore understudied aspects in current research on induced and organic participation and thus contribute to transforming current development perspectives on social and societal change. The project thus aims at contributing to three major emerging fields: First, to the growing research interest in an ‘anthropology of the good’ through its emphasis on the ways in which people engage with each other to make a ‘better life’. Secondly, to the newly evolving ‘anthropology of insurance’ through its combined multi-level analysis and in-depth ethnographic research on social health protection as a social practice. Third, by engaging in a public dialogue, we hope that our insights will be discussed, contested, and appropriated by some of these ‘stakeholders’ and thus make a difference in the comprehension of the important contemporary issues of social health protection reform and more general societal change.
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