Table 1.

The three districts and their relations to country health system structures

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

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