Abstract This article traces a shift in how hospital workers at a Tanzanian public hospital thought about their workplace. In 2010, for the first time, staff began collectively imagining what they called ‘a real hospital’. This collective dreaming of institutional possibilities emerged due to two transformations: a shift in Tanzanian government policies enabling government institutions to initiate their own ‘public–private partnerships’ (PPPs) with non-state ‘partners’ such as NGOs, private businesses, investors, missionary organizations and others; and the hospital's early successes in attracting (a few) partners. Unlike familiar global PPPs such as the Global Fund to Fight AIDS, Tuberculosis and Malaria, Tanzania's PPP policy allowed health facilities to initiate their own partnerships in order to improve public services. Drawing on longitudinal ethnographic research in one government hospital, this article traces successful, failed and fraught partnership initiatives through which public-sector health workers tried to improve hospital infrastructure and capacity. In tracing institutional aspirations and local workers’ efforts to achieve them through homegrown PPPs, this article highlights the contingency and malleability of public and private spheres operating within public health service provision in Tanzania, as well as the opportunities available to health workers and the constraints involved in attempting to improve hospital care.

中文翻译：

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“像真正的医院”：通过坦桑尼亚本土的公私伙伴关系想象医院的未来

摘要 本文追溯了坦桑尼亚公立医院的医院工作人员如何看待他们的工作场所的转变。2010 年，员工们第一次开始集体想象他们所谓的“真正的医院”。这种对制度可能性的集体梦想源于两个转变：坦桑尼亚政府政策的转变，使政府机构能够与非国家“合作伙伴”（如非政府组织、私营企业、投资者、传教组织和其他组织；以及医院在吸引（少数）合作伙伴方面的早期成功。与全球抗击艾滋病、结核病和疟疾基金等熟悉的全球 PPP 不同，坦桑尼亚的 PPP 政策允许卫生机构建立自己的伙伴关系，以改善公共服务。本文利用在一家政府医院进行的纵向民族志研究，追溯了成功、失败和令人担忧的伙伴关系举措，通过这些举措，公共部门卫生工作者试图改善医院的基础设施和能力。在追踪机构愿望和当地工人通过本土 PPP 实现这些愿望的努力时，本文强调了在坦桑尼亚公共卫生服务提供范围内运作的公共和私营领域的偶然性和可塑性，以及卫生工作者可用的机会和所涉及的限制试图改善医院护理。