This thesis comparatively explores the recent NPM inspired reforms in Norway and Tanzania, with a focus on the effects of reforms, particularly whether they are ‘post-bureaucratic’ or not. Preference for post bureaucracy is a characteristic of the discourse of New Public Management, which has been influential in the public sector reforms globally. The study focuses on decision making process in the respective countries health sectors after the reforms. It might be expected that the enterprises or the lower hierarchies would reflect post bureaucracy both in dominant management and organizational discourse. However, the study does not confirm that these health systems have become post bureaucratic. The reforms appear to break with the stated aims of great structural devolution and delegation. New forms of control, management by contract and results have emerged replacing management by command with hierarchy, specialization and standardization remaining important. In this regard, the article discusses possible reasons for bureaucracy resilient despite the discourse of NPM. Here, necessity to good public management, rationalization, paradox of social action and a need of integrated perspective are the highlighted attributes in the discussion.