Domination and Autonomy

Domination and autonomy was the category which denoted the two opposing attitudes observed in the studied Councils. ‘Domination’ describes the practice of the officials at the Council level, as well as the Government, to dictate important

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decisions to the lower levels. ‘Autonomy’, in contrast, portrays the desire of the members at the Council and lower levels to make their own decisions. Domination and autonomy, therefore, denotes the influence of higher levels to control the lower levels and the desires of the lower levels to be independent. For instance, despite the fact that the health facilities maintained their own banking arrangements, the use of any part of the funds, including those collected under the Cost Sharing Scheme, were required to be duly approved and authorised at the Council level. Whilst the officials at the Council level maintained that the arrangement was an important ‘check and balance’ mechanism, members at the low level viewed the arrangement as a form of domination which increased unnecessary financial bureaucracy:

“For the Cost Sharing Scheme, everything in terms of the management and collection of the funds are done here. Though, expenditure of any amount should be authorized and approved by the Council Medical Officer and the Council Director… We have teeth but we cannot bite. This is the big problem in our Council” (Reme, Health Centre Medical in Charge: KAMC) (emphasis added).

The situation was worse in the KBDC, where all funds from the Cost Sharing Scheme were maintained in one account at the Council level24, a practice which contradicted the financial regulations of the scheme, which required each health facility to maintain its own accounts. Despite the fact that the Council’s higher officials regarded the practice as necessary in the early stage of the scheme25, officials at the low level were not convinced. A similar trend was noted in MCDC, where a Cost Sharing Scheme had yet to be introduced, as all health funds were still maintained, authorised, and approved at the Council level. Interestingly, the same trend was noted in relation to some donor funded projects such as Health Basket Fund, where the authorisation, approval, as well as the maintenance of the funds remained at the Council level. This had led to discontent amongst the technocrats:

“All funds [Health Basket Fund] are just maintained in a single account at the Council level. We don’t know even our balances. We are not even sure as whether

24

As at the end of the fieldwork (October 2011), the Council had 18 health facilities comprised of 14 Dispensaries, 3 Health Centres, and 1 District Hospital.

25

Accounting Practices in the Tanzanian Local Government Authorities (LGAs): Page 116 they use our funds to finance other activities or not? It could be appropriate if we have our own funds to our own account and let Council officials come for supervision. We have two qualified accountants here, I don’t know why they cannot

give our portion of the Basket Fund” (Meha, Hospital Medical In-charge: KAMC) (emphasis added).

Among other things, the quote illustrates the legitimating role of accounting in the health facilities. When accounting practices were perceived to have improved, the technocrats felt that the Hospital were legitimate to handle, and accounted for their own funds without passing through the Council. The implication of the legitimating role of accounting is explored further in the following three chapters.

A high level of domination was noted in the MDMC, where the health practitioners were not even aware of the availability of the Health Basket Fund allocated to their health facilities. The low level of participation in the health budgets, and the absence of budget feedback contributed to this anomaly. Of the four Councils visited, it was only the MDMC where the Comprehensive Council Health Plan was not available in the all health facilities visited. In general, high levels of Councils’ domination had had a negative impact on the delivery of the public services, especially in the outreach Councils, such as KBDC and MCDC. Because the primary schools and health facilities of these Councils were located in very remote areas which could not accessed easily, centralization of the payment procedures normally delays the provision of services. This was the major reason for an ‘under-banking strategy’ noted in some of the health facilities. Nevertheless, autonomy was somewhat improved in the Primary Education sector. Compared with the health facilities, all primary schools maintained their own and separate bank accounts for the capitation and development grants, and schools’ financial decisions were made by the Primary School Committee (PSC). However, as with the health facilities, the final authorization and approval of the funds was made at the Council level.

On the other hand, the operations of the Councils were directly and indirectly controlled by the Government. The Government, through the PMO-RALG and other sectoral ministries, exercised direct and indirect control of the Councils’ operations through the enactment of relevant laws, approval of the Councils’ by-laws and

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regulations, approval and monitoring of the Councils’ budgets, issuing the relevant policies and guidelines, and the disbursement of a variety of funds. The Government was also responsible for performance monitoring, capacity building, and human resource development. The overall reaction among Councils’ officials was for the Government and other regulatory authorities to refrain from interfering with the daily operations of the Councils.