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Table 1 The three districts and their relations to country health system structures

From: The accountability for reasonableness approach to guide priority setting in health systems within limited resources – findings from action research at district level in Kenya, Tanzania, and Zambia

Levels

Mbarali, Tanzania

Malindi, Kenya

Kapiri Mposhi, Zambia

International

Presence of many organizations and programs – both state and non-state actors

National

Ministries for Health and Social Welfare and for local government

MOH (later divided into two)

MOH

Subnational

Cross-sectorial region, Health Zone (Health sector only)

Province – moving to a smaller unit County structure

Province

District

Council Health Team

District Health Team

District Health Team

Council Health Services Board

District Health Board

District Health Board

District Hospital Board

District Hospital Board

District Hospital Board

Decentralization to local government, but professionally overseen by MOH (devolution)

Decentralization under MOH (deconcentration).

Decentralization under MOH (deconcentration)

First line facility

Health center/clinic and dispensary/health post; MOH, private for profit and not-private for profit.

Community

Local structures and committees, (CSOs), NGOs, users and communities

Local structures and committees, CSOs, NGOs, users and communities

Local structures, neighborhood committees, CSOs, NGOs, users and communities

  1. CSO, Civil Society Organization; MOH, Ministry of health.