Kamuzora, PeterMaluka, StephenSan Sebastian, MiguelMtasingwa, LilianKapologwe, NtuliHurtig, Anna-Karin2023-03-282023-03-282023-03http://hdl.handle.net/20.500.11810/6028A research project entitled “Examining the effects of decision-making space and its practices on health systems performance in Tanzania” was conducted in twenty districts of Tanzania between 2020 and 2023. The main objective of this research was to better understand and evaluate how and if decentralised sub-national structures used the opportunities to improve the performance of health systems. Two universities: the University of Dar es Salaam, Tanzania and Umeå University, Sweden, collaborated in the implementation of this project. To understand the opportunities that Tanzania’s decentralization structure has to offer, this research focused on the decision-making space provided to officials at the local levels over the health system functions of planning, financing, human resources, service delivery, and governance. Tanzania’s decentralization policy allows Health Facility Governing Committees (HFGCs), on behalf of the communities, to participate in these health system functions. The HFGCs consisting of community members have become integral in the decentralization reforms which have been implemented since 1990s. The government expects health care providers to involve HFGCs in the management of health facilities, including making decisions that best serve the interests of the community. HFGCs should be involved in decisions such as approving all transactions that are made at the health facilities, inspecting health commodities procured by health facilities prior to dispensing, taking part in the making of plans and budgets of health facility and holding health care providers accountable for the performance of their health facilities. This policy brief synthesizes the key findings of the research conducted to assess how HFGCs participated in the implementation of functions that have been decentralized to the district level in Tanzania.enCommunity ParticipationHealth facility governing committeesHealth systemTanzaniaOther