opulation policies have rarely been linked to economic policy, although the promoters of economic liberalisation also support the embrace of population policy as important to the economic wellbeing of African states. Using a case study from Tanzania, I argue that population policies with a limited focus on fertility reduction may continue to be successful in the context of post-adjustment African health care systems, but policies that aim for the larger goals of improving women's reproductive health will be severely limited. Tanzania's donors and lenders promoted Neo-Malthusian types of population policies aimed primarily at reducing childbearing as a partial solution to the country's economic crisis. However, in the mid-1990s, the international discourse on population shifted toward a new dependent variable of ‘women's reproductive’ health. The notion of reproductive health reunites population and development issues in the context of basic health care provision. Improvements in the reproductive health of Tanzanian women will require more than simply the effective provision of contraceptives. This article argues that the challenges of improving reproductive health are unlikely to be met without a revitalisation of public health care provision in African countries.