This study analyzes local health finances in Tanzania by considering the extent to which public health resources in Tanzania flow from the district government level to primary health facilities, or whether these resources get stuck at the district level. Our analysis of health expenditures in six rural Local Government Authorities suggests that less than half of local health funding reaches the front-line dispensaries that provide the vast majority of local health services. The structure of the local health system appears to favor top-down interventions and control, rather than empowering local facilities to improve local health outcomes.
Topic:
Health, Health Care Policy, International Development, and Cities
The role of local governance within global development is approaching an important inflection point. To the extent that local governments function as effective platforms for collective local decision-making and as effective mechanisms for promoting the collective interests of their constituents, local governments are ideal partners for achieving development success. Moreover, regardless of the mechanism or type of decentralization or “localization” that is ultimately chosen, in the end, we cannot ignore the vertical governance mechanisms and multilevel service delivery mechanisms that are needed to ensure the effective delivery of public services at the local level.
Topic:
Governance, International Development, Services, and Decentralization