This article examined community participation in the delivery of water and primary health care services in the Local Government Authorities (LGAs) in Tanzania. This was the descriptive research study which employed both qualitative and quantitative research designs involving a total of 208 respondents. Where 127 respondents filled in the questionnaires, 51 respondents participated in the in-depth interviews and 30 respondents participated in the Focus Group Discussions (FGDs). The results indicate that decentralization reforms have facilitated the formation of health and water services governance structures that facilitate community participation in the service delivery. The findings further revealed the means through which community participated in the delivery of services, i.e. , from participating in the meetings, project initiation and management, to membership in various statutory services boards and committees.
KeywordsDecentralizationCommunity ParticipationService DeliveryLocal Government
Tatar, M. (1992) Health for All by the Year 2000 and Primary Health Care: The Turkish Case. Unpublished PhD Thesis, University of Nottingham, Nottingham.
World Health Organization (1978) The Alma-Ata. International Conference on Primary Health Care, Alma-ATA, USSR, 6-12 September 1978.
Quin, A., Berit, B. and Jellan, K. (2011) How to “Walk the Talk”: The Perspectives of Sector Staff on Implementation of the Rural Water Supply in Uganda. National Resources Forum, 35, 269-282. https://doi.org/10.1111/j.1477-8947.2011.01401.x
Islam, N. (2003) Decentralized Governance and Development in India: A Study in West Bengal. PhD Thesis, University of Mysore, Mysore.
Crook, R.C. (2003) Decentralization and Poverty Reduction in Africa: The Politics of Local-Central Relations. Public Administration and Development, 23, 77-88. https://doi.org/10.1002/pad.261
Bardham, P. and Mookherjee, D. (2000) Capture and Governance at Local Levels. American Economic Review, 90, 135-139. https://doi.org/10.1257/aer.90.2.135
Agarwal, B. (2001) Participatory Exclusions, Community Forest, and Gender: An Analysis for South Asia and Conceptual Framework. World Development, 29, 1623-1648.
Mandara, C.G. (2014) What Policy Says and Practice Does: Gender Households and Communities in Rural Water Provision in Tanzania. PhD Thesis, Wageningen University, Netherlands.
Masanyiwa, Z. and Anke, N. (2013) Institutional Arrangements for the Decentralized Water and Health Services Delivery in the Rural Tanzania: Differences and Constraints. Basic Research Journal of Social and Political Sciences, 1, 77-88.
Hiskey, J.T. (2010) The Promise of Decentralized Governance. In: Connerley, E., Eaton, K. and Smoke, P., Eds., Making Decentralization Work: Democracy, Development and Security, Lynne Rienner Publishers, Boulder London.
World Health Organization (2008) Decentralization in Client Countries: An Evaluation of World Bank Support 1990-2007. The World Bank Publications, Washington DC.
Mills, A. (1990) Decentralization Concepts and Issues: A Review. Part 1. In: Mills, A., Vaught, J.P., Smith, D.L. and Tabibzadeh, I., Eds., Health System Decentralization: Concepts, Issues and Country Experience.
The United Republic of Tanzania (1977) The Constitution of United Republic of Tanzania. Government Printers, Dar es Salaam.
The United Republic of Tanzania (1998) Policy Paper on Local Government Reform. Local Government Reform Programme, Dar es Salaam.
Rweyemamu, A.H. and Mwansasu, B., Eds. (1974) Planning in Tanzania: Background to Decentralization. East African Bureau, Nairobi.
Samoff, J. (1979) The Bureaucracy and Bourgeoisie: Decentralization and Class Structure in Tanzania. Comparative Studies in Society and History, 21, 30-62. https://doi.org/10.1017/S0010417500012640
Picard, L.A. (1980) Attitude and Development: The District Administration in Tanzania. African Studies Review, 23, 49-67. https://doi.org/10.2307/523671
Conyers, D. (1981) Decentralization for Regional Development: A Comparative Study of Tanzania, Zambia and Papua New Guinea. Public Administration and Development, 1, 107-120. https://doi.org/10.1002/pad.4230010203
Apthorpe, R. and Conyers, D. (1982) Decentralization, Recentralization and Popular Participation towards a Framework for Analysis. Paper presented to Programme in Communication Policy and Planning, for Development, Institute of Social Studies, The Hague, June 1982.
Rondinelli, D., Nellis, J.R. and Cheema, G.S. (1983) Decentralization in Developing Countries. A Review of Recent Experience. World Bank Working Papers No. 581, Washington DC.
Rondinelli, D.A. (1990) Decentralization, Territorial Powers and the State: A Critical Response. Development and Change, 21, 491-500. https://doi.org/10.1111/j.1467-7660.1990.tb00385.x
Smith, B.C. (1985) Decentralization: The Territorial Dimension of the State. Allen and Unwin, London.
Ngasongwa, J. (1988) Evaluation of Externally Funded Regional Integrated Development Programmes (RIDEPS) in Tanzania: Case studies of Kigoma, Tanga and Iringa Regions. Unpublished PhD Thesis, School of Development Studies, University of East Anglia, Norwich United Kingdom.
Mukandala, R.S. (2004) Local Government, Effectiveness and Human Rights: The Case of Bukoba Rural and Mtwara-Mikindani Districts in Tanzania. International Council on Human Rights Policy (ICHRP).
Liviga, J.A. (2010) Local Government Reforms in Tanzania. REDET.
Venugopal, V. and Yilmaz, S. (2010) Decentralization in Tanzania: An Assessment of Local Government Discretion and Accountability. Public Administration and Development, 30, 215-231. https://doi.org/10.1002/pad.556
Shivji, I. and Peter, C. (1999) A Review of Legal Institutional frame of Governance at Sub-District Level in Context of Local Government Reform Programme. Unpublished manuscript.
United Republic of Tanzania (1996) Local Government Reform Agenda. Ministry of Regional Administration and Local Government Administration, Dar es Salaam.
Maluka, S. (2011) Strengthening Fairness, Transparency and Accountability in the Health Care Priority Setting at District Level in Tanzania: Opportunities, Challenges and the Way Forward. PhD Thesis, Umea University, Sweden.
Wills, K. and Khan, S. (2009) Health Reform in Latin America and Africa: Decentralization, Participation and inequalities. Third World Quarterly, 30, 991-1005. https://doi.org/10.1080/01436590902969742
Tideman, P. (2008) Local Level Service Delivery, Decentralization and Governance: A Comparative Study of Uganda, Kenya and Tanzania. Education, Health and Agriculture Sectors, Tokyo, Japan, Institute for International Cooperation.
Biswas, A.K. (2001) World Water Forum: In Retrospect. Water Policy, 3, 351-356.
De Palencia, F.J.A. (2010) Key Challenges in the Governance of Rural Water Supply: Lessons Learnt from Tanzania. Unpublished PhD Thesis, Polytechnic University of Catalonia, Barcelona.
Sutton, S. (2008) The Risks of Technology-Based MDG Indicators for Rural Water Supply. www.rwsn.ch
Garriga, G.R. (2007) Strategy Comparison of Implementation of Water Supply Points and Their Sustainability in Tanzania: A Review of Alternatives Approaches to the Sustained Provision of Water Supplies in Tanzania. Unpublished Masters of Science in Environmental Engineering and Sustainable Development, Imperial College, London.
United Republic of Tanzania (2002) National Water Policy. Ministry of Water, Dar es Salaam.
United Republic of Tanzania (2005) Medium Term Plan and Budget July 2005-June 2008. Local Government Reform Programme, Dar es Salaam.
United Republic of Tanzania (2007) Household Budget Survey 2007. National Bureau of Statistics, Dar es Salaam.
Shivji, I.G. and Peter, C.M. (2003) Village Democracy Initiative Report Dodoma. President’s Office-Regional Administration and Local Government.
Chaligha, A. (2008) Local Autonomy and Citizen Participation in Tanzania: From a Local Government Perspective. Special Paper No. 08, REPOA.
Rutinwa, B. and Shivji, I.G. (2006) Building Consensus on the Policy of Decentralization by Devolution and Methodologies for Harmonization of Sector Policies and Legislations. The Local Government Reform Program, Dar es Salaam, 40.
Shillingi, V. and Mutalemwa, D.V. (2012) Health Services Delivered by the Bukoba Municipal Council: What Has Quality Got to Do with It? ESRF Discussion Paper No. 43, The Economic and Social Research Foundation.
Gilson, L., Kilima, P. and Marcel, T. (1994) Local Government Decentralization and the Health Sector in Tanzania. Public Administration and Development, 14, 415-477. https://doi.org/10.1002/pad.4230140503
Frumence, G., Nyamhanga, T., Mwangu, M. and Anna-Karin, H. (2013) Challenges to the Implementation of Health Sector Decentralization in Tanzania: Experiences from Kongwa District Council. Global Health Action, 6, Article No. 20983. http://www.biomedcentral.com/10.342/gha.v6i0.20983 https://doi.org/10.3402/gha.v6i0.20983
Parestico, P. (2010) The Dynamics of Public Struggle for Local Autonomy in the Post-1990s Tanzania: Cases of Muleba and Kinondoni Districts. Masters of Arts (Political Science and Public Administration) Dissertation, University of Dar es Salaam, Dar es Salaam.
Masanyiwa, Z., Anke, N. and Catrien, J.M.A.T. (2014) Cooperation and Trust in the Context of Decentralization Reforms in Tanzania. International Journal of Social Science and Human Studies, 6, 139-156.
United Republic of Tanzania (2003) National Health Policy. Ministry of Health, Dar es Salaam.
Mubyanzi, G., Kamugisha, M., Mushi, A. and Blas, E. (2004) Implication of Decentralization for Control of Tropical Dieses in Tanzania: A Case Study of Four Districts (Babati, Lushoto, Muheza and Mkuranga). International Journal of Health Planning and Management, 19, S167-S185.
Mubyanzi, M. (2007) Local Primary Health Care Committees and Community-Based Health Workers in Mkuranga District, Tanzania: Does the Public Recognize and Appreciate Them? Etho-Medical Journal, 1, 27-35.
WHO (2002) Community Participation in Local Health and Sustainable Development: Approaches and Techniques. European Sustainable Development and Health Series No. 4.
Kyessi, G.A. (2003) Community-Based Urban Water Management in Fringe Neighborhood: The Case of Dar es Salaam, Tanzania. Habitat International, 23, 1-25.
Pals, S. (2011) Support to Community Management of Water in Sengerema District, Tanzania. Unpublished Masters of Science in International Development Studies, Utrecht University, Utrecht.
Smoke, P. (2003) Decentralization in Africa: Goals, Dimensions, Myths and Challenges. Public Administration and Development, 23, 7-16. https://doi.org/10.1002/pad.255
Galiwago, H.W. (2008) Decentralization and Development: The Contradictions of Local Governance in Uganda with Specific Reference to Masindi and Sembule Districts. PhD Thesis, Nelson Mandera Metropolitan University.
COWI/EPOS (2007) Joint External Evaluation of the Health Sector in Tanzania: A Draft Report. Dar es Salaam.
Kessy, F.L. (2014) Improving Health Services through Community Participation in Health Governance Structures in Tanzania. Journal of Rural and Community Development, 9, 14-31.
Isham, J. and Kahkonen, S. (1999) What Determine the Effectiveness of Community-Based Water Projects? Evidence from Central Java, Indonesia, on Demand Responsive, Service Rules, and Social Capital. Social Capital Initiatives Working Paper No. 14, World Bank, Washington DC.
Ademun, R.S. (2009) Domestic Water Supply: An Evaluation of the Impacts.
Asiimwe, J.M. and Nakanyike, B.M. (2007) Decentralization and Transformation of Governance in Uganda. Fountain Publishers Ltd., Kampala.