Browsing by Author "Kabyemela, Matrona"
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Item Democratization and public accountability at the grassroots in Tanzania: the case of Bukoba district(University of Dar es salaam, 2010) Kabyemela, MatronaThe purpose of this study was to examine public accountability at the grassroots within the context of the democratization process that started in 1992 in Tanzania. Specifically it intended to examine the formal structures and processes at the grassroots which are likely to influence accountability, if the necessary prerequisites for effective accountability regime at the village level are in place and wether citizens’ actual behaviour toward their village government influences or contributes to accountability at the grassroots. Relevant literature related to democratization and public accountability was reviewed and a theoretical framework based on the principal agency theory guided the study. The case study was conducted in four wards of Bukoba district with 120 respondents including village citizens, village government leaders and autonomous association leaders. These respondents were obtained through purposive, simple random and convinience sampling techniques. Data were gathered through questionnaires, interviews, observations and a review of documents and were qualitatively and quantitatively analysed. The study revealed that there minimal changes had taken place in the daily functioning of the village government at the grassroots resulting from the democratization process. The study noted that citizens at the grassroots perceived themselves as unable to hold their village government accountable. This was because of the legal provisions and regulations guiding the functioning of the village government, poor flow of information between the village government and the citizens, the low level of civic competence and the generally poor participation of the citizens in the decision-making process. There is a call for an amendment of existing laws and regulations governing the functioning of the village government, to intensify the provision of civic education to citizens and village government leaders by the central government, local government, policy makers and civic groups. Also the study recommends the use of a variety means of communication to supplement the village assembly. Finally, the study recommends further studies to explore any variations in citizen’ ability to demand accountability from local government leaders between urban and rural settings and from district council.Item Health service delivery systems in Tanzania an investigation of how traditional medicine coexists with biomedicine in Bukoba District(University of Dar es Salaam, 2017) Kabyemela, MatronaThe purpose of this study was to examine the way in which Traditional Medicine (TM) coexists with biomedicine in the delivery of health services in Tanzania and to examine the effects of such coexistence on health service delivery in rural areas in the country. In particular, the study sought to find out whether the existing policy and legal framework enables TM to interact with biomedicine, that is, whether TM complements, accommodates, competes with or substitutes for biomedicine. The literature on modernity and tradition was reviewed so as to identify a conceptual and theoretical framework for this study. The main argument is that, although they are different, traditional and modem elements coexist in various societies in the world and that such coexistence has certain effects on the functioning of any sociopolitical organization. Thus, the study employed Helmke and Levitsky’s (2004) model of formal and informal institutions in comparative politics to establish how TM and biomedicine coexist and to determine the effects of such coexistence on health service delivery in rural areas in Tanzania. The study was conducted in five wards of Bukoba district and involved 50 respondents, namely household respondents, traditional health practitioners (THPs), the Chairperson of Kagera Regional TBAs and THPs Association, the Registrar of TM, biomedical practitioners and the Director of the Institute of TM. The respondents were obtained using purposive, snowball and convenience sampling techniques. The data were gathered through interviews, observations and a review of relevant documents, and they were analyzed qualitatively. The findings show that, although TM is, to some extent, perceived as an inferior system by the 1996 National Health Policy and various laws, it complements and accommodates biomedicine in health service delivery. They also show that TM is highly involved in the treatment of non-communicable and chronic diseases which cannot be treated by biomedicine in rural areas. Therefore, it complements and accommodates biomedicine by increasing the accessibility and availability of health services in such areas. However, the current coexistence of the two systems is likely to lead to such health-related problems as deaths, drug reactions and body weaknesses due to the concurrent use of TM and biomedicine or to abrupt discontinuation of either a TM dosage or a biomedical one. Thus, the Government should develop a TM policy that details the structures, functions and administration of TM from the national level to the village level without biomedicine unnecessarily interfering with TM. Moreover, the ongoing TM formalization process should go hand in hand with a review of the relevant laws so that THPs and biomedical practitioners may collaborate effectively in providing health services in the country. Finally, the study recommends further examination of how TM coexists with biomedicine in urban areas and of how biomedicine coexists or interacts with TM in rural areas.