Lufunyo, Hussein
(2017)
An Assessment of Decentralisation Effectiveness on Public Health Service Delivery in Rural Tanzania: A Case Study of Pangani and Urambo Local Government.
Masters thesis, The Open University Of Tanzania.
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Abstract
This study aimed to assess the Effectiveness of Decentralisation on the delivery of Public Health Services in rural Tanzania drawing experiences from Pangani and Urambo Local Government Authorities (LGAs). The study adopted a case study design and employed mainly qualitative approach to address the problem. The study used mixed data collection methods and technique, analysis was mainly qualitative. The study established that; for the past fifteen years decentralisation had decimal effects on improving Public Health Service Delivery in Rural Tanzania. Institutional characteristics and legal frameworks posed hindrances for full fruition of intended effectiveness of decentralisation on health service delivery in rural Tanzania. With decentralisation, health services were characterised by a number of shortcomings that affected access and quality. The establishment of health centres and supply of needed equipments, drugs and medicines, health workers, distance, complaints handling mechanisms and responsiveness remained as problems. Delayed service provision, poor time management by staff, minimal accountability and transparency, minimal political will, poor records management, shortage of health workers and resistance to change characterised public health service, remained so, and persisted. The study recommends a review and re alignment of the legal frame, administrative systems, structures and processes. Improvement on human resource for health and integration of decentralisation with other sector reforms is a crucial. There is also need for increased leadership commitment and political will, timely resource allocation, public awareness building and having home grown reforms and involvement of Local Government Authorities also recommended.
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