Local Government Reform Programme and Health Service Delivery in Kasulu District, Tanzania

摘要

The study investigates how the local government reforms shaped health service delivery in Kasulu District council. Firstly, the study intended to find out how reforms assisted management of quality and capacity to offer health services in Kasulu. Secondly, the study examined the challenges to offer adequate and quality health services in Kasulu District. The other objective was to assess how health service reform attracted community involvement in planning and implementation of health services in Kasulu. The expo-facto descriptive design used to explore changes after the health service reforms in Kasulu. Whereby, the interest was to know both challenge and improvement encountered through the reforms undertaken. The study involved ( ) respondents as a sample to represent the whole population in the study area. A structured questionnaire was administered to health service officers and heads of household in order to fill in questions. The questionnaire analyzed through frequencies and mean which were presented in percentages, charts as well as figures. The percentage distribution formed a basis for conclusions. It was revealed that there were inadequate health facilities and staffs; this led into poor service provision. For instance, still there is good number of people trust traditional healers than doctors. This is due to poor services offered such as unsuccessful treatment, long waiting and inadequate expertise. The Local Government Reform Programme (LGRP) was formulated and implemented by the Tanzania Government with an intention of addressing problems which constrained the performance of the local government authorities such as the human resource capacity and management being weak and this seriously constrained performance by Local Government Authorities, weak leadership and poor management of the councils, shortage of properly qualified, disciplined and committed personnel, shortage of revenue due to narrow tax base, over-employment within the Councils and lack of transparency and accountability in the conduct of Councils' business. The study concludes that effectiveness of health service delivery is mainly determined by both local government system and the community involvement. That is local government policy reforms, critical resources management and full engaged community. From which the community can play their role to promote a dynamic health delivery environment. Keywords: Service delivery, Local Government Reform Programme, Accountability and Local Government Authorities