Browsing by Author "Kessy, Ambrose"

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    Decentralization and citizens’ participation: Some theoretical and conceptual perspectives
    (Taylor & Francis, 2013) Kessy, Ambrose
    Although the terms decentralization and citizens’ participation sound familiar to scholars and policy makers, their meanings, forms and scope are controversial in the current literature of local governance. The usage of these terms appears to be restricted to abstraction. For instance, the question of measurement has been highly contested in the literature such that any discussion concerning more power to the people and improvement of local governance is “often viewed by critics as no more than a theoretical exercise.”The critical question therefore is how to move these terms from their state of abstraction to a concrete reality. The purpose of this article is therefore to review some theoretical and conceptual issues on decentralization and citizens’ participation in order to question the often-emphasized positive relationship attached to them and their empirical application.
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    Developing learning diaries for action research on healthcare management in Ghana, Tanzania and Uganda
    (SAGE, 2016) Mshelia, Comfort; Leˆ, Gillian; Mirzoev, Tolib; Amon, Samuel; Kessy, Ambrose; Baine, Sebastian Olikira; Huss, Reinhard
    Action research (AR) can be an effective form of ‘on the job’ training. However, it is critical that AR cycles can be appropriately recorded in order to contribute to reflection and learning. One form of recording is for coresearchers to keep a diary. We found no previous literature describing the use of diaries in AR in sub-Saharan Africa. We therefore use this paper to reflect on how diaries were used by district health management teams in the PERFORM project. We share five lessons from our experience. First, it is important to foster ownership of the diary by the people who are responsible for filling it in. Second, the purpose of keeping a diary needs to be clear and shared between researchers and practitioners from the very beginning. Third, diaries should be allowed to evolve. Fourth, it is a challenge for busy practitioners to record the reflection and learning processes that they go through. Last, diaries on their own are not sufficient to capture reflection and learning. In conclusion, there is no best way for practitioners to keep a diary; rather the focus should be on ensuring that an AR recording process (whether diary or otherwise) is locally owned and complements the specific practice setting.
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    Essential medicine stock-outs in rural primary health care–exploring the contribution of politics and resulting perceptions in Kasulu district, Tanzania
    (International Society for Development and Sustainability (ISDS), 2018) Kessy, Ambrose; Bana, Benson; Damian, Respicius Shumbusho
    Stock-outs of essential medicines and medical items remains a persistent problem in Tanzania, despite the several policy initiatives and interventions since the 1990s. We conducted a qualitative case study, which involved 24 in-depth interviews and eight focus group discussions with the Community Health Fund stakeholders who were facility incharges, grassroots leaders, and members of Health Facility Governance Committees from eight primary health facilities in Kasulu District Council. The analysis involved transcribing and coding textual data to identify the key themes that emerged. The study identified four main themes that explained how the politics contribute to persistent stock outs, especially: 1) stock-outs as capital in electoral politics; 2) misinformation and rent-seeking; 3) dyads among street-level bureaucrats; and 4) competition and struggle for power and control over resources. We also identified four themes reflecting the dominant perceptions associated with stock-outs in the study communities namely: 1) feeling marginalized; 2) mistrust and suspicion of authority; 3) frustration of health workers; and 4) informal drug sellers as ‘the best'. These perceptions influence the way communities tend to define their role in health care financing and governance as well as the relationship between communities and health workers. While economic, administrative, and technical forces might influence stock outs, the politics within the management and governance of the Community Health Fund, which included rent-seeking, misinformation, and competition, significantly affected the legitimacy of the Community Health Fund. The resulting low enrollment and unwillingness to contribute makes medicines’ financing from community sources unsustainable. Therefore, empowering communities to mobilize locally available resources and exercise autonomous control over financial resources and medicine is imperative for addressing persistent stock outs.
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    Intergovernmental fiscal relations in Tanzania: Guidelines or directives?
    (Mkuki na Nyota Publishers Ltd, 2018) Mushi, Richard; Kessy, Ambrose
    As a unitary state, Tanzania has relied on intergovernmental fiscal regime to ensure that all LGAs equitably receive funding for execution of its mandates and responsibilities. Uncertainty in resource mobilization has hampered effective implementation of fiscal transfers to the LGAs. Intergovernmental fiscal resources are ring-fenced and leave limited discretion to LGAs to reallocate resources based on prevailing demands. Improvement in intergovernmental fiscal relations requires putting in place more effective mechanisms for allocating and disbursing resources between the central government and the LGAs. Decision making relating to intergovernmental fiscal allocation to LGAs often excludes the participation of LGAs.
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    Local governance in Tanzania: Observations from six councils 2002-2003
    (Mkuki na Nyota Publishers Ltd, 2007) Chaligha, Amon; Henjewele, Florida; Kessy, Ambrose; Mwambe, Geoffrey
    Governance entails participation, transparency, efficiency and equity in the management of people and their economy in a given country. Governance comprises the mechanisms, processes and institutions, through which citizens and groups articulate their interests, exercise their legal rights, meet their obligations and mediate their differences. Local governance refers to the way a local authority fulfils its responsibilities towards the citizens in their areas of jurisdiction. It covers relationships between local authority leaders and the citizens, as well as political parties and non-governmental organisations, and the central government in all phases of formulating policies that affect people in carrying out their daily activities. In this study, several political and administrative dimensions of governance are discussed. First is the issue of Local Government Autonomy. Here, an attempt was made to answer the question: To what extent are the local authorities free to make political decisions within the Tanzanian polity? It is recognised that the local government reforms has opened the way for multi-level planning systems and new, non-hierarchical forms of inter-ministerial coordination. However, while the decentralisation reform has set the stage for participatory local planning practices, it is by no means guaranteeing them. Improved trust relations, citizens’ rights, reduced corruption, participation in local elections and gender mainstreaming are important governance issues that are also discussed in this study.