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Key Text Decentralisation and Gender: Coordination and Cooperation on Maternal Health Issues in Selected District Councils in Tanzania

Author: Liss Schanke, Siri Lange (eds)
Date: 2008
Size: 93 pages (1.2 MB)

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Summary

How do Local Government Administrations (LGAs) in Tanzania coordinate and cooperate to reach gender-related goals? This study, published by the Chr. Michelsen Institute, identifies good practices in examining how five district councils cooperate with local communities, civil society organisations and the private sector to improve maternal health, and how well different departments within district councils coordinate their work. Structural problems, partly linked to financial issues, impede sustainable cooperation between local government and civil society. Cooperation with the Department for Community Development is central to enhancing participation and including lower local government levels.

Since the 1996 Local Government Reform Programme, Tanzania has committed itself to a policy of “decentralisation by devolution” to improve service delivery and empower local communities. At the same time, the government has signed global agreements committing itself to gender equality. Improved service delivery and decision making at local government level are key gender issues.

Maternal health has proved to be an important entry point for understanding governance and gender issues, yielding concrete and useful data. The study considers both horizontal co-operation (between local government and NGOs), and vertical cooperation (between local government and NGOs and local communities). Findings include the following:

The responsibility of ensuring cooperation has rested largely with local government authorities, and the degree of actual coordination varies widely.
Challenges to vertical cooperation include: responding to needs; ensuring bottom up approaches; achieving knowledge through the grass roots; reaching common understandings; mobilising the grassroots for development; and cooperating with and exploiting informal networks.
Challenges to horizontal cooperation include: ensuring information flow and coordination; creating openness and communication; clarifying the roles of NGOs, private sector and local government actors; preventing overlap between NGOs and the private sector and between
NGOs and local government; balancing urban, peri-urban and rural areas; and ensuring access to services for the poor.
A new mechanism - called a Local Government Capital Development Grant - has provided crucial basket funding for all but one of the districts examined.
There is insufficient funding to support coordination between government and civil society - for civil society participation at meetings and seminars, for example.
Access to external funding varied greatly. One district contained a disproportionate number of like-minded donor-funded projects.
Specific logistical concerns mattered. In all districts, the Department for Community Development lacked transport and fuel, relying instead on other departments to make visits. This severely limited the department's ability to mobilise the community on maternal health issues.

The district administration can improve cooperation and coordination through measures such as coordinating its departments with a regular Council Management Team meeting and attracting better staff talent. Closer involvement with NGOs and mobile outreach and radio and ambulance equipment are also important. Among other recommendations are the following:

Health facilities, which women should be encouraged to use more regularly, should train personnel in detecting premature delivery signs and sensitise women about nutrition and hygiene issues. Facilities should ideally include maternity waiting homes, when possible, to aid patients from remote areas.
Village Health Committees should be responsible for tracking pregnancies and for promoting birth preparedness among women. Greater incentives should be created for village health workers.
Where traditional birth attendants are preferred to hospitals, those attendants should receive training in premature delivery problems and meet with district health workers.
In local governments in Tanzania, women are generally underrepresented in political and administrative posts and in key areas such as health and education. Promotion of women in these roles is needed in order to work towards gender balance.

NB: The project was financed by Norad. A film/slide show connected to the project can be found at: http://maweni.com/mimba.

Access full text: available online

Source: Schanke, L. and Lange, S. (eds), 2008, 'Decentralisation and Gender: Coordination and Cooperation on Maternal Health Issues in Selected District Councils in Tanzania', Chr. Michelsen Institute, Bergen
Author: Siri Lange , siri.lange[at]cmi.no