Decentralization by Devolution; Perceptions of Councilors on the Level of their Decision Making Authority in Local Government Experience from Tarime Town Council

Abstract

Early 1990s governments across the South have embarked on democratic decentralization reforms aimed at introducing and strengthening local governance because of its assumed potential to improve the delivery of public services and alleviate poverty. To comply with that international practice, in early 2000 Tanzania government decide embarked on an ambitious Local Government Reform Program that addressed Political decentralization. Political decentralization signaled the government"s commitment to enhance the decision making authority of local government councils on matters affecting local development including determining priorities for local development, land use, finance, service delivery and human resource management. This paper sought to find out whether the selected local government council led by councilors enjoys the development planning, and service delivery authority as established in the local government law. The findings have confirmed that the case study council enjoyed modest decision making authority in the areas of local development planning, selecting local development strategy, and enjoyed even greater authority over service delivery powers.

The Functionality of Health Facility Governing Committees and Their Associated Factors in Selected Primary Health Facilities Implementing Direct Health Facility Financing in Tanzania

“…Empirical evidence suggests that user committees known as HFGCs provide the link between health care providers and communities 8, 12 . In the primary health facilities, the HFGCs is responsible for providing leadership in holding service providers accountable, hence addressing the problem of misuse of resources, poor service provision, and poor health system responsiveness to the community 7,13 . The LMICs have assigned speci c functions to be performed by HFGCs, such as managing nance and addressing community health challenges 12,14 .…”

“…Therefore, the attainment of good health, among others, depends on community participation in the planning and implementation of health service delivery at the primary health care facilities (PHC) 4 . Lower and Middle-Income Countries (LMICs) adopted community participation in health service delivery in primary health care through decentralization by devolution policies, which created Health Facility Governing Committees (HFGCs) [5][6][7] . The created HFGCs are devolved with speci c functions and powers to perform in the course of governing primary health care facilities 8,9 .…”

“…Abimbola et al in Nigeria found that HFGCs were not performing well in their role because some members did not know their role and had limited scal power and authority to manage facility resources 17 . To unlock the HFGCs functionality gaps, the literature suggests the implementation of full decentralization ( scal, political, and administrative) at primary health care facilities 7,[18][19][20] . Currently, some LMICs are implementing scal decentralization through various arrangements in primary health facilities among other things to empower and improve HFGCs' functionality.…”

The quest for accountability of Health Facility Governing Committees implementing Direct Health Facility Financing in Tanzania: A supply-side experience

“…The Principal/Agent Theory marches with the accountability definition that entails the “relationship between an actor and a forum, in which the actor has an obligation to explain and to justify his or her conduct, the forum can pose questions and pass judgment, and the actor may face consequences” [ 9 ]. Communities, civil societies, and other interest groups are the primary/forum in which they have assigned their responsibilities to control primary health care facilities through the HFGCs [ 8 , 19 , 20 ]. HFGCs, on the other hand, are agents/actors who are democratically elected by the principal or forum, which is a community or a group of interest groups.…”

The Accountability of Health Facility Governing Committees and its Associated Factors in Selected Primary Health Facilities Implementing Direct Health Facility Financing in Tanzania

“…The Principal/Agent Theory marches with the accountability de nition that entails the "relationship between an actor and a forum, in which the actor has an obligation to explain and to justify his or her conduct, the forum can pose questions and pass judgment, and the actor may face consequences" [9]. In the context of primary health care governance, communities, civil societies and other interest groups are Principal/Forum in which they have delegated their responsibilities to govern primary health care facilities to the HFGCs [13], [18], [19]. On the other hand, HFGCs are agents/actors that are democratically elected by the Principal or forum which is communities or interest groups.…”