Table 3.

Comparison of the process of AFR introduction in the three districts

Steps in establishment	Mbarali, Tanzania	Malindi, Kenya	Kapiri Mposhi, Zambia
Sensitization of stakeholders. Number of recorded sessions	From 2007 and including community members; 6 sessions	From 2008, not going beyond the hospital team; 3 joint sessions	From 2007 including already coopted NGO and increasing to others including representatives of communities
Effective start of application	2008	2009	2008
Number of ART meetings and of planning meetings referring to AFR	Total 18 ART and 4 planning meetings. Report to CHMT. Other meetings.	Total 3 ART meetings. Report to DHMT. No record of other meetings.	Monthly meetings for AFR associated with DHMT meetings and thus also taken up in plans
ART members regularly involved	2 researchers, 5 CHMT members	1 researcher, 3 DHMT members	4 DHMT members. Researcher presence irregular
Focal person/observer	Junior scientist 2009-10	Scientist for irregular periods	Only as ad hoc visits by a researcher.

AFR, Accountability for Reasonableness; ART, Action Research Team; CHMT, Council Health Management Team; DHMT, District Health Management Team.