Browsing by Author "Maluka, Stephen O."

Now showing 1 - 5 of 5
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    advantages and risk of economic partnership agreement
    (2007-10) Maluka, Stephen O.
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    Challenges to Fair Decision-Making Processes in the Context of Health Care Services: A Qualitative Assessment from Tanzania
    (BioMed Central, 2012) Shayo, Elizabeth H; Norheim, Ole F; Mboera, Leonard E G; Byskov, Jens; Maluka, Stephen O.; Kamuzora, Peter; Blystad, Astrid
    Fair processes in decision making need the involvement of stakeholders who can discuss issues and reach an agreement based on reasons that are justifiable and appropriate in meeting people’s needs. In Tanzania, the policy of decentralization and the health sector reform place an emphasis on community participation in making decisions in health care. However, aspects that can influence an individual’s opportunity to be listened to and to contribute to discussion have been researched to a very limited extent in low-income settings. The objective of this study was to explore challenges to fair decision-making processes in health care services with a special focus on the potential influence of gender, wealth, ethnicity and education. We draw on the principle of fairness as outlined in the deliberative democratic theory.
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    Decentralization and Health Care Prioritization Process in Tanzania: from National Rhetoric to local Reality
    (2011) Maluka, Stephen O.; Hurtig, Anna-Karin; Sebastián, Miguel S; Shayo, Elizabeth; Byskov, Jens; Kamuzora, Peter
    During the 1990s, Tanzania like many other developing countries adopted health sector reforms. The most common policy change under the health sector reforms has been decentralization, which involves the transfer of power and authority from the central level to local authorities. Based on the case study of Mbarali district in Tanzania, this paper uses a policy analysis approach to analyse the implementation of decentralized health care priority setting. Specifically, the paper examines the process, actors and contextual factors shaping decentralized health care priority setting processes. The analysis and conclusion are based on a review of documents, key informant interviews, focus group discussion, and notes from non-participant observation. The findings of the study indicate that local institutional contexts and power asymmetries among actors have a greater influence on the prioritization process at the local level than expected and intended. The paper underlines the essentially political character of the decentralization process and reiterates the need for policy analysts to pay attention to processes, institutional contexts, and the role of policy actors in shaping the implementation of the decentralization process at the district level. Copyright © 2010 John Wiley & Sons, Ltd.
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    Implementing Accountability for Reasonableness Framework at District Level in Tanzania: a Realist Evaluation
    (BioMed Central, 2011) Maluka, Stephen O.; Kamuzora, Peter; SanSebastián, Miguel; Byskov, Jens; Ndawi, Benedict; Olsen, Øystein E; Hurtig, Anna-Karin
    Despite the growing importance of the Accountability for Reasonableness (A4R) framework in priority setting worldwide, there is still an inadequate understanding of the processes and mechanisms underlying its influence on legitimacy and fairness, as conceived and reflected in service management processes and outcomes. As a result, the ability to draw scientifically sound lessons for the application of the framework to services and interventions is limited. This paper evaluates the experiences of implementing the A4R approach in Mbarali District, Tanzania, in order to find out how the innovation was shaped, enabled, and constrained by the interaction between contexts, mechanisms and outcomes
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    Promoting Community Participation in Priority Setting in District Health Systems: Experiences from Mbarali District, Tanzania
    (Co-action Publishing, 2013) Kamuzora, Peter; Maluka, Stephen O.; Ndawi, Benedict; Byskov, Jens; Hurtig, Anna-Karin
    Community participation in priority setting in health systems has gained importance all over the world, particularly in resource-poor settings where governments have often failed to provide adequate publicsector services for their citizens. Incorporation of public views into priority setting is perceived as a means to restore trust, improve accountability, and secure cost-effective priorities within healthcare. However, few studies have reported empirical experiences of involving communities in priority setting in developing countries. The aim of this article is to provide the experience of implementing community participation and the challenges of promoting it in the context of resource-poor settings, weak organizations, and fragile democratic institutions.