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31. Triggering Increased City-Level Public Finance for Pro-Poor Sanitation Improvements

Author:
Jameson Boex and Benjamin Edwards
Publication Date:
01-2015
Content Type:
Research Paper
Institution:
Urban Institute
Abstract:
This paper provides a general framework for understanding the political economy and fiscal determinants of sanitation service provision by urban local governments. The paper will address several questions: what do we expect to influence spending on local sanitation? Do different fiscal instruments have an impact on expenditure levels? Do increased local revenues lead to increased expenditures over the long term? What role do different stakeholders play in determining expenditure levels? The paper first looks at the role of political factors in constraining local expenditure decisions, then turns to a review of the fiscal determinants of service delivery expenditures.
Topic:
Political Economy, Governance, Urban, Sanitation, Services, and Cities
Political Geography:
Global Focus

32. Decentralized Local Health Services in Tanzania: Are Health Resources Reaching Primary Health Facilities, or Are They Getting Stuck at the District Level?

Author:
Jameson Boex, Luke Fuller, and Ammar A. Malik
Publication Date:
04-2015
Content Type:
Research Paper
Institution:
Urban Institute
Abstract:
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
Political Geography:
Africa and Tanzania