Institutional Characteristics and Its Effect on Public Health Service Delivery under Decentralization in Local Government Authorities in Tanzania

This article examines the effects of institutional characteristics on public health service delivery under decentralisation in rural Tanzania. It adopted a cross sectional design to examine institutional characteristics and its effects on health service delivery at Pangani and Urambo Local Government Authorities (LGAs). Both qualitative and quantitative approaches were employed; primary data were collected by using interviews, questionnaires, FGDs and observation. The study established that, the instructional characteristics impaired significantly the decentralisation initiatives for improved health service delivery in the rural areas in Tanzania. Institutional characteristics, legal frame work, systems and administrative structures were the main hindrance in the implementation of decentralisation for improved health services and its delivery. The institutional effects resulted to poor health service delivery infrastructures in terms of equipments availability, drugs and medicines, health workers, distance, delayed service, time management, lack of accountability and transparency. The study recommends a review of the existing framework, administrative systems, structures and processes and human resource capacity building.