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Since the 1990s, Tanzania has been implementing health sector reforms including decentralization of primary healthcare services to districts and users. The impact of the reforms on the access, quality and appropriateness of primary healthcare services from the viewpoint of users is, however, not clearly documented. This article draws on a gendered users' perspective to address the question of whether the delivery of gender-sensitive primary health services has improved after the reforms. The article is based on empirical data collected through a household survey, interviews, focus group discussions, case studies and analysis of secondary data in two rural districts in Tanzania. The analysis shows that the reforms have generated mixed effects: they have contributed to improving the availability of health facilities in some villages but have also reinforced inter-village inequalities. Men and women hold similar views on the perceived changes and appropriateness to women on a number of services. Gender inequalities are, however, reflected in the significantly low membership of female-headed households in the community health fund and their inability to pay the user fees and in the fact that women's reproductive and maternal health needs are as yet insufficiently addressed. Although over half of users are satisfied with the services, more women than men are dissatisfied. The reforms appear to have put much emphasis on building health infrastructure and less on quality issues as perceived by users.

Increasing participation in decision-making processes by service users is one of the objectives of decentralisation reforms in Tanzania. The argument is that decentralisation enhances participation by all sections of the community, and by women in particular, and results in decisions that better reflect local needs. This paper examines the impact of decentralisation reforms on service users' participation for delivery of water and health services in rural Tanzania, using a gender perspective and principal-agent theory. The paper investigates how decentralisation has fostered spaces for participation and how men and women use these spaces, and identifies factors that constrain or encourage women's participation. It shows that decentralisation reforms have created spaces for service users' participation at the local level. Participation in these spaces, however, differs between men and women, and is influenced by the socio-cultural norms within the household and community. Men have gained more leverage than women to exercise their agency as principals. Women's participation is contributing to addressing practical gender needs, but strategic gender needs have been less adequately addressed because gendered power relations have been largely untouched by the reforms.

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The aim of this study to investigate the impact of decentralisation by devolution on farmers' access to agricultural extension services in selected villages in Dodoma, Tanzania. The specific objectives of the study are (i) to examine the availability and distribution of agricultural extension staff at ward and village levels and (ii) to examine farmers' accessibility to agricultural extension services at the local level. Data for the study were collected from a sample of 273 farmers in three wards of Hombolo, Kikombo and Chigongwe, using questionnaire survey, semi-structured interviews, focus group discussions and documentary review. Data analysis techniques involved descriptive statistics, chi-square test and qualitative content analysis. The findings show that implementation of decentralisation has contributed to increased availability and distribution of agricultural extension staff at the ward and village levels. This has enhanced farmers' access to several agricultural extension services. Nevertheless, the number of extension staff is still far below to meet the needs of farmers, partly because Local Government Authorities do not have the discretion to recruit their staff which is still under the mandates of the Central Government. It is recommended that local government authorities should be given more authority and mandates to recruit extension staff according to their needs.