Doctoral thesis
This thesis investigates the implications of participatory planning on the quality of the decentralised health service delivery in the public health facilities of Dodoma City and Bahi District Councils in Tanzania.It specifically dealt with the quality of health service delivery in the public health facilities, the participatory activities, the level of planning, and decision-making practices for health service delivery in the LGAs. The thesis is built on the Public Choice Theory and Service Quality (SERVQUAL) Model and the extension of the inward understanding of the subject with the empirical literature. A concurrent mixed research approach was employed throughout data collection and analysis. The study adopted the cross-sectional design to collect data from 440 respondents. Similarly, the study collected both quantitative and qualitative data from primary and secondary sources by using survey questionnaires, interviews, focus group discussions, observations, and documentary reviews. Both probability and non-probability procedures were used to select different units of the study. The quantitative data were analysed using descriptive and inferential statistics while the qualitative data were analysed thematically. Cronbach’s Alpha was used to test the reliability of the variables. The research findings revealed that the respondents are dissatisfied with the quality of health service delivered in public health facilities. Also, the quality of health services in the public health facilities was significantly influenced by participatory activities and decision-making practices in the Local Government Authorities. Generally, the findings imply a mismatch between the assumptions of Public Choice Theory on participatory planning and the quality of the decentralised health service delivery. It is recommended that the government and community members develop appropriate strategies to improve the quality of health service delivery. The strategies include the establishment of the Tanzania Health Fund for Local Government Authorities (THF-LGAs) and ensuring the availability of modern equipment for health service delivery in both urban and rural councils of Tanzania.