A 1999 survey of District Health Management Teams (DHMTs) in Tanzania provides information on the progress of the decentralization process in that country. The objectives of the survey were to monitor the extent of the decentralization process and to collect information on decentralization's achievements and limitations to date. The survey represents a unique source of data since information was collected from the actual "on-the-ground" implementors of the decentralization process. The survey found that while decentralization has been ongoing for over a decade, at least rhetorically, less than half of DHMTs report that decentralization is underway in their districts and the actual transfer of administrative and fiscal responsibilities is still limited for the majority of districts. Most districts are heavily reliant on external funding and report that they have control over only a small proportion of their budgets. For those districts in which decentralization is ongoing, the decentralization process is reported to be associated with improvements in a variety of areas: availability of district funds, coordination with donors, ability to attract and retain staff, and use of government health services.