Background: Public-private partnership in the health sector was introduced to improve the delivery of health services in Tanzania. Contrary, the expected outcomes have not been fully realised. This study aimed at investigating challenges encountered in implementing public-private partnership institutional arrangements in health service delivery in Kinondoni Municipality, Dar es Salaam, Tanzania. Methods: A qualitative case study design was employed, where in-depth interviews with stakeholders were held and document reviews conducted. Fourteen (n = 14) participants engaged in this study. Eight (n = 8) and six (n = 6) of the fourteen participants were from the public and private sector respectively. The thematic approach was used to analyse data, and ethical principles in the research process were upheld. Results: Findings revealed that although public-private partnerships are hailed for supplementing the government's efforts in the provision of health services, institutional arrangements for the smooth provision of these services are lacking. Several challenges encumber smooth provision of health services and these include inadequate resources, ineffective monitoring and evaluation, and insufficient consultations between partners. Conclusion: Inadequate legal and policy framework, or ineffective implementation practices may influence challenges facing institutional arrangements for public-private partnerships. Therefore, strengthening of publicprivate partnerships is recommended to improve implementation mechanisms and practices such as adherence to partnership agreements and compliance to the policies, laws and regulations.

Background: Public-private partnership in the health sector was introduced to improve the delivery of health services in Tanzania. Contrary, the expected outcomes have not been fully realised. This study aimed at investigating challenges encountered in implementing public-private partnership institutional arrangements in health service delivery in Kinondoni Municipality, Dar es Salaam, Tanzania.Methods: A qualitative case study design was employed, where in-depth interviews with stakeholders were held and document reviews conducted. Fourteen (n=14) participants engaged in this study. Eight (n=8) and six (n=6) of the fourteen participants were from the public and private sector, respectively. The thematic approach was used to analyse data, and ethical principles in the research process were upheld.Results: Findings revealed that although public-private partnerships are hailed for supplementing the government’s efforts in the provision of health services, institutional arrangements for the smooth provision of these services are lacking. Several challenges encumber smooth provision of health services and these include inadequate resources, ineffective monitoring and evaluation, and insufficient consultations between partners.Conclusion: Inadequate legal and policy framework, or ineffective implementation practices may influence challenges facing institutional arrangements for public-private partnerships. Therefore, strengthening of public-private partnerships is recommended to improve implementation mechanisms and practices such as adherence to partnership agreements and compliance to the policies, laws and regulations.

The level of corruption practices in the process of accessing land in peri-urban areas is agreeably enormous in Tanzania. The Democratic Governance Theory (DGT) anticipated curbing corruption in land related issues through advocating equality, equity, transparency and rule of law among others. This study aims to find out the extent at which the Democratic Governance Theory is upheld in Tanzania in a bid to fight corruption in the entire process of accessing land among the peri-urban dwellers. The study was conducted in Dar es Salaam City and deployed a case study methodology approach. Primary data employed household survey using questionnaire and in-depth interview with key informants where as secondary data collected includes government reports, research reports, books and articles. Findings from the study reveal that, despite emphasis of DGT's by the Government of Tanzania corruption is still serious problem in land accessibility. Land accessibility procedure was seen to be complicated, non-transparent and too bureaucratic. Lastly, anticorruption agencies were ineffective and inefficient, thus fail to check corrupt practices in the land circles. The study concluded that DGT has not adequately helped the country in the fight against corruption. The Government of Tanzania should therefore, consider comprehensive and participatory reforms in land tenure regime, land accessibility procedure and anti-corruption agencies. It is imperative to integrate modern information technology in the process of accessing land, so as to reduce frequent contact between land seekers and government officers.

Abstract:The deterioration of health services provision in Tanzania from 1980s to 1990s made decentralization of health service provision through the Health Sector Reform (HSR) a necessity. HSR aimed at bringing better utilization of scarce resources, improved quality of health services, increasing user access and cutting rising costs. It is through HSR that health insurance schemes were introduced. Community Health Fund (CHF) came as a result of such efforts. The efficiency and effectiveness of CHF rests on district councils which are responsible for ensuring better performance of CHF. Although the Government of Tanzania targeted 85% of the population to be members of CHF, enrollment has remained as low as 9.2% by 2014. The most sticking problem is the variation in enrollment in different districts. There are districts with higher performance in CHF enrollment like Iramba (54%) and Bariadi (40.9%). Whereas, there are districts with very low enrollments in CHF like Liwale (8%), and Rungwe (6.5%). This paper is an effort to shed some light on this phenomenon ofperformance variation of CHF enrolment in districts. It argues that poor performing districts are constrained by their own weaknesses such as poor management and leadership capacities of Council Health Management Team (CHMT) and lack of motivation among health facility staff and allied health workers. Also, poor sensitization and mobilization of people to join CHF, as well as poor quality healthcare to people has deterred performance of CHF in some districts. The papers' conclusion apart from offering recommendation also adds to the broader ongoing debate of decentralization process mainly through health insurance.

Often times people are told by government officials that there are limited financial resources to finance different development projects/programmes and to provide assistance for self help. This view is also held by the academic world. This is usually taken as an absolute truth and usually as an excuse for the limited socio-economic development of the citizens and societies. While this may be true, we propose a problematisation of this by gathering and making sense of evidence from the annual audit reports for the Local Government Authorities (LGAs) in Tanzania. The central aim of the proposed paper therefore is to show the fallacy of "the limited resources" by arguing that it is not a matter of limited resources but whether and how the available resources are put to intended use for development and poverty reduction goals. The relevance of this is to shift focus on development resources available to whether and how the extent to which the resources are put to use and to establish whether LGAs are keeping people into poverty by using or not using the available resources.

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Background: The public-private partnership in the health sector, which was introduced to improve the delivery of health services, has existed for decades in Tanzania. Contrary, the anticipated outcomes have not been realised. This paper attempts to underscore the challenges that have permeated the provision of health services under public-private partnerships. Methods: A qualitative case study design was used. Institutional arrangements under public-private partnerships in the delivery of health services was used as a case. Fifteen (n=15) in-depth interviews were conducted with participants from both the public and private sector. Relevant documents were also reviewed to inform this study. Results: Findings revealed that, although public-private partnerships is hailed for supplementing government’s efforts in the provision of health services, institutional arrangements for the smooth provision of these services is lacking. Several challenges including inadequate resources, ineffective monitoring and evaluation of public-private partnerships performance, insufficient consultations between partners as well as varying goals and strategies were noted. Conclusion: Challenges facing institutional arrangements for public-private partnerships may either be influenced by inadequate legal and policy framework as well as ineffective implementation practices. Therefore, effective and smooth interface can be achieved by strengthening implementation practices through development of strong and adequate supportive policy framework that can ensure adherence to contractual agreements.

Background: Public-private partnership in the health sector was introduced to improve the delivery of health services in Tanzania. Contrary, the anticipated outcomes have not been fully realised. This study aimed at investigating challenges encountered in the implementation of public-private partnership institutional arrangements in health service delivery in Kinondoni Municipality, Dar es Salaam, Tanzania.Methods: A qualitative case study design was used, where in-depth interviews with stakeholders were held and document reviews conducted. Fourteen (n=14) participants engaged in this study. Eight (n=8) and six (n=6) of the fourteen participants were from the public and private sector respectively. Thematic approach was used to analyse data and ethical principles were upheld in the research process.Results: Findings revealed that although public-private partnerships are hailed for supplementing the government’s efforts in the provision of health services, institutional arrangements for the smooth provision of these services is lacking. Several challenges encumber smooth provision of health services and these include inadequate resources, ineffective monitoring and evaluation, as well as insufficient consultations between partners.Conclusion: Challenges facing institutional arrangements for public-private partnerships may either be influenced by inadequate legal and policy framework, or ineffective implementation practices. Therefore, strengthening of public-private partnerships is recommended to improve implementation mechanisms and practices such as adherence to partnership agreements and compliance to the policies, laws and regulations.