What was the immediate stakeholders' response to decentralization of Expanded Program on Immunization at district level in Tanzania? Analysis of quantitative and qualitative data from a range of stakeholders was done. The immediate response included reduced cooperation, delayed financial disbursement, reduced supervisions and low EPI coverage (52.8 percent). It was concluded that there was a need to increase awareness of decentralization and management capacity at district level to facilitate positive alignment of the stakeholders.

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