The many undertakings that have been classified to be PPP projects in Tanzania, were largely concluded without PPP policy, legal, institutional and strategy for its implementation. But, having realized that PPPs could provide best developmental option for the sources of funding and technology if well prepared, coordinated and undertaken; as from 2009 important steps were put in place. These constitute a complex interplay of policy, legal and regulatory framework under which PPPs projects in Tanzania can successfully be mainstreamed to support the realisation of the Tanzania Development Vision 2015 and social services provision in particular. The paper accounts for PPPs implementation as a tool for health service delivery for both effectiveness and efficiency—value-for-money a previously purely government-run domain in Tanzania.