Abstract In rural Uganda, pregnant women struggle to access clinical care because of limited access to transportation and other barriers to travel, including delays in the maintenance and modernization of rural road infrastructure. This article analyses one community-led effort to address these gaps by providing free motorbike transport to pregnant women during labour. The programme is considered alongside broader trends in global health funding, in particular the rise of ‘appropriate technologies’, or the promotion of cheap, adaptive and flexible interventions that stand in contrast to an earlier focus in international health on building and modernizing state infrastructures for all. Drawing on anthropological studies of infrastructure, this article explores how qualities such as flexibility, improvisation and collaboration may radically expand healthcare infrastructure while also creating conditions of uneven use and inconsistencies of access that expose the limitations of targeted interventions. In its focus on the political and relational nature of infrastructures, this article highlights how healthcare projects are dependent as much on access to ‘hard’ healthcare resources (ambulances, medical technology) as they are on historically rooted, deeply localized and unevenly accessed webs of relations that shape access and connection to such resources, and that extend beyond clinical spaces.
Lydia Boyd (Sat,) studied this question.