Background: Improving community health in many developing nations requires synergetic leadership. The concept of public-private partnership in health and social care initiatives was adapted to improve health outcomes in many developing countries; the implementation lacks community leadership engagement to promote ownership and accountability of health and social health outcomes Objectives: To understand strategies that could promote community partnership leadership engagement to enhance ownership and accountability on health and social care initiatives, and to increase awareness of primary health care collaborative initiatives needs in Tanzania, the developing nation. Methods: Empirical qualitative case study used. Twenty-six leaders and managers responded to in-depth one-on-one interviews and partnership national policies and guidelines documents reviewed. Content analysis and NVivo 11 software employed to analyse collected data. Results: Two major themes emerged. Firstly, findings indicated that integrated supportive supervision, teamwork, and strategic communications promote leadership synergy. Secondly, the findings showed that limited data, unclear roles and responsibilities, limited understandings of the benefits of Public-Private Partnership at the community level hinder the promotion of ownership and accountability of health and social initiatives. Conclusion: The results of this study indicate significant evidence of improving population health through promoting community leadership ownership and accountability of health and social care initiatives. Also, this study finding provides insight into supporting community leadership synergies for the implementation of primary health care initiatives in a partnership setting. Further studies are needed to explore partnership and community engagement in provision of primary health initiatives in private for-profit health organisations. In addition, this study contributes to the strategic development goal 3.