Electronic Thesis and Dissertation Repository

Thesis Format

Integrated Article


Doctor of Philosophy



Collaborative Specialization

Global Health Systems in Africa


Dr. Isaac Luginaah


This dissertation examines the psychosocial health and wellbeing impacts of Large Scale Land Acquisitions (LSLAs) in coastal Tanzania. Contemporary acquisition of large parcels of land in low-income countries by investors is both transformational and a neo-colonization strategy depending on the philosophical frame and scale of analysis. Despite multiple narratives about its impacts across scale, there is consensus in the conceptualization of LSLAs as a global force that is changing local ecologies and communities. Yet, the impact of these changes on the psychosocial health and wellbeing of local populations is less evident. This study employs mixed methods that combines qualitative and quantitative approaches in order to understand how three interrelated concepts in LSLAs—changing local landscapes, ecological governance and multiple vulnerabilities—explain differentiated psychosocial health and wellbeing impacts of LSLAs among local populations.

Results from qualitative analysis of in-depth interviews (n=37) show that LSLAs is destructive to therapeutic spaces, and thus adversely impacting the psychosocial health of local populations. The quantitative analyses (n=1,782) reveal widespread perception of poor ecological governance in LSLAs context—only 7% of the population reported good ecological governance. Individuals with poor (OR=3.00, p≤0.01) and fair (OR=4.22, p≤0.001) perception of ecological governance were more likely to report poor psychosocial health as they worry over the sustainability of their environments. Regarding how multiple vulnerabilities structure LSLAs impact on food insecurity (a predictor of psychosocial distress), the quantitative analyses further show migrant women were the most adversely impacted overall, and that male non-migrants (OR=1.58, p≤0.05) were worse impacted compared to female non-migrants. The study also found that with the influence of climate change, LSLAs impact on non-migrants’ food insecurity is reduced (women=2.4%; men=0.2%), while migrants’ food insecurity is exacerbated (women=1.4%; men=1.7%).

The study makes important contributions to theory, methodology and policy. Theoretically, by demonstrating how LSLA is associated with psychosocial health, the study extends ecological change and health framework into the analysis of health in LSLAs literature. Also, the finding that non-migrant males are more vulnerable to food insecurity impact of LSLAs demonstrates gender-based complexities in long-term impacts of ecological change. Applying therapeutic landscapes in LSLAs is helpful in broadening the conceptualisation of lands in LSLAs context, while disparities in psychosocial health impacts extends the utility of social determinants of health. Methodologically, the study demonstrates the value of mixed methods in analysis of complex phenomena such as psychosocial health and LSLAs. The findings in this study amplify the need to introduce health considerations into LSLA policymaking in Tanzania, and similar context. Importantly, the findings challenge the viability of Tanzania’s national development agenda (vision 2025), which heavily relies on LSLAs.

Summary for Lay Audience

Changes to our environment through human activities and climatic change are directly linked with our health and wellbeing. In these environmental health impacts, poor and vulnerable individuals in our communities are often the most adversely impacted because of their limited access to basic needs including food. In low-income countries, most populations directly depend on land/environmental resources for livelihoods and other health related services, and therefore, understand that protecting the environment is protecting their health and wellbeing. Beyond our basic understanding of the impact of environmental change on health, how it occurs has been an important area of research. This research explains how investment in large parcels of land, one form of environmental change, impacts on the psychosocial health and wellbeing of local populations in coastal Tanzania. It also identifies individuals most at risk of suffering poor psychosocial health and wellbeing as a result of land investments.

Large scale land investments have been on the rise in low-income countries in the last decade (since 2007/2008). As of July 2019, about 1,662 land deals, each of which involved at least 200 hectares, were concluded globally, taking up about 49 million hectares of land. Approximately 60% of these land deals occur in Africa. The search for stable investment portfolio, energy and global food security, and economic growth in low-income countries are the main considerations pushing land investments.

Analysis of in-depth interviews (n=37) and surveys (n=1,782) revealed important pathways through which large scale land investments influence processes of ecological governance, changes community landscapes, and exacerbates socio-economic inequalities, which together impacts psychosocial health and wellbeing of local populations. The research found widespread perception of poor governance of environmental resources in localities where land acquisitions were taking place, highlighting the extent to which land investment interest corrupts and weakens local environmental governance practices. Individuals with awareness of poor ecological governance were three times more likely to report poor psychosocial health as they experience adverse changes to their livelihoods, and distress over the sustainability of their environments and communities. Additionally, it became apparent from the research that land investments take-up/destroy sacred lands (therapeutic spaces) known to provide healing and good health for communities and individuals, thereby contributing to poor psychosocial health. Finally, contrary to the general notion that land investments improves local food security, the research found that 8 in every 10 individuals indicated land investments were resulting in food insecurity. Male non-migrants were the most vulnerable as their land is taken up by investors. However, in the context of climate change, migrants were more vulnerable to the food insecurity impact of land investments. Given these findings, it is important to change course by de-emphasis the role of land investments while prioritising the development of local strategies to address food insecurity, climate change effects and health challenges in low-income countries.