Devolution And Community Participation In Health Service Delivery In Tanzania: Case Of Chigongwe Ward, Dodoma Municipality

ABSTRACT

This study focused on devolution and community participation in health service delivery in Tanzania. The study had three objectives, namely to examine community participation on fiscal transfers‘ decision making under devolution system, to examine community participation in personnel or human resource management in health service delivery under devolution system; and to examine community participation on transfers of effective decision making authorities under devolution system. A sample of 60 respondents was used and these were randomly obtained from the study area. Primary and secondary data sources were used in this study. The study employed data collection methods such as interviews, questionnaire and documentary review. The findings show that much efforts is needed for devolving powers and authority from the central government to the local government to facilitate community participation and quick decisions for local development as a key challenge for the health sector in many parts of the poorer developing countries (including Tanzania). Systems should be established at local level to ensure the devolved services such as health services reach ordinary citizens. The study recommends that nation as a whole should focus not only on gradual but comprehensive transfer of power, responsibilities and resources from the central to local governments and hence community participation. The findings of this study can be applied to other regions or the whole country. This is because; all the regions in Tanzania have similar structures and system of governance. Therefore it can help in finding and applying pertinent solutions.