This research concerns logistics performance in public purchasing relationships, and explores the effect of buyer-supplier integration on supplier logistics performance. The research focuses in particular on purchasing centralization in health care facilities, and examine whether centralization of purchasing decision control exercised by the health authorities will influence the effect of buyer-supplier integration on supplier logistics performances at the firm level in health care facilities.Purpose This research concerns logistics performance in public purchasing relationships, and explores the effect of buyer-supplier integration on supplier logistics performance. The research focuses in particular on purchasing centralization in health care facilities, and examine whether centralization of purchasing decision control exercised by the health authorities will influence the effect of buyer-supplier integration on supplier logistics performances at the firm level in health care facilities. Design/methodology/approach This research is based on basic organization theory, inter-organizational theory, and supply chain management literature, and examines the combined effect of purchasing centralization and supplier integration on supplier logistics performance based on survey data from 164 key informants from public health institutions in Tanzania. Findings The analysis reveals that stronger buyer-supplier integration improves supplier logistics performance significantly, and that stronger centralization of purchasing decision control by the health authorities reduces the effect of more extensive buyer supplier integration on supplier logistics performance at the firm level. Research limitations/implications Public health institutions in Tanzania are highly regulated and controlled by public authorities, and this might limit the external validity of this study. Possible effects of opportunistic behaviour among public agents might also influence the outcome of the analyses, and further research in other empirical settings and cultural settings is desirable to test the external validity of the empirical findings. Practical implications The local government should focus more on supporting the individual public health facilities in developing and adapting proper governance mechanisms for their supplier integration, and be aware of the advantages associated to the alignment of independent and local supplier coordination at the institutional level. Social implications Strong bureaucratic decision control and possible opportunistic behaviour among public agents and employee in public medicine institutions might represent a threat against a smooth and effective organization of the medicine supplies in the public sector. Original/value The study provides a valuable theoretical contribution to the supply chain management research. In particular, the combination of significant contributions from basic organization theory, principal-agent theory and supply chain management literature provides a broad and interesting focus on significant antecedents to supplier logistics performance.