Abstract
BackgroundDevelopment assistance for health represents an important source of health financing in many low and middle-income countries. However, there are few accounts on how priorities funded through Development assistance for health are integrated with district health priorities. This study aimed at understanding the operational challenges of engaging development partners in district health planning in Tanzania MethodsThis explanatory mixed methods study was conducted in Kinondoni and Bahi districts. A structured checklist to 35 participants collected quantitative data whereas a semi-structured guide collected qualitative from 20 key informants (the council health planning team members and the development partners) to obtain information related to engagement of development partners in the planning processes and subsequent implementation of the district plan. We used descriptive analysis for quantitative data and thematic analysis for qualitative data ResultsMajority (86%) of the development partners delivering aid in the studied districts were Non Governmental Organizations. We found high engagement of Development partners (DPs) (87.5%) in Bahi district and very low in Kinondoni district (37.5%). Guidance on district priorities to be included in Development partner’s plans as part of the Comprehensive Council Health Plan (CCHP) was given to 36% of the Development partners. Submission of written plans to be integrated in the District plans was done by only 56% of Development partners, with majority (77.7%) from Kinondoni district not submitting their plans. Only 8% of the submitted plans appeared in the final District plan document. Qualitative findings reported operational challenges to engagements such as differences in planning cycles between the government and donors, uncertainties in funding from the prime donors, lack of transparency, limited skills of district planning teams, technical practicalities on planning tools and processes, inadequate knowledge on planning guidelines among DPs and poor donor coordination at the district level. ConclusionsWe found low engagement of Development partners in planning. To be resolved are operational challenges related to differences in planning cycles, articulations and communication of local priorities, donor coordination, and technical skills on planning and stakeholder engagement.