Title:
How not to decentralise : accountability and representation in health boards in Tanzania
Authors:
Boon, S.
Place:
The Hague
Publisher:
SNV Netherlands Development Organisation
Year:
2007
Series Title:
SNV publications
Serial number:
H0702-08
PAGE:
24
Language:
eng
Subject:
Health and Nutrition
Keywords:
health services
,
decentralization
,
governance
Abstract:
As decentralization expands in Africa, local management structures are also likely to become more important. The paper investigates issues of representation of and accountability to users of public services in local management structures. The study challenges the assumption that user representation in such structures enables users to voice their interests and makes services better adjusted to their needs. The findings reveal that because selection is not democratic, representatives see themselves as primarily accountable to government and not to their communities. The government dominates the selection process of members to the boards and committees. The perception of members on their role is mainly government-focused. It came out clearly that the represented communities, voluntary agencies and private health providers do not have a forum for consultation and raising issues. Voluntary agency and for-profit health providers’ representation is low. One of the recommendations is to use democratic elections.
Note:
Paper for presentation at the European Conference of African Studies
organised by the Africa-Europe Group for Interdisciplinary Studies.
London: 29 June – 2 July, 2005
Organization:
SNV - Netherlands Development Organisation
Country:
Tanzania, United Republic of
Region:
Africa South of Sahara
,
East Africa
Category:
Research
Right:
© 2007 SNV
Document type:
Report
File:
115694.pdf