The middle, or district, tier of administration is the borough of Taunton Deane.
Health services are organized around a three tier system at district level, with the district hospital as the referral level, the health centre at subdistrict level, and the Community Health and Planning and Services (CHPS) compounds, which deliver close-to-client services mostly at home, at community level.
There are four tiers of care at the district level: general hospital, health centres at the county-level (health centre of level IV), sub county level (health centre of level III) and parish level (health centre of level II).
Ninety-two percent of the unqualified providers (Bangladesh is divided in 64 districts, second tier for administrative purposes) have district level training and more than 96% have specific training on hypertension (22).
Prenatal care services are delivered through a three-tier perinatal care network system consisting of primary hospitals, district level WCHC (including secondary hospitals) and a city level WCHC (including tertiary hospitals).
The three-tier network of community mobilizers (community level, block level, and district level) does the main work of the SM Net.
At district level, the core of facilitators already trained by the project could be part of provincial /district /cluster level tiers.
The health system is decentralized at district and health sub-district level with no regional tier.
The Tories oppose the moves, saying that two-tier district and county councils are closer to communities and more democratic.
Heseltine has long advocated a unitary, or single-tier structure of local government throughout England (broadly similar to Scotland and Wales) and the abolition of 201 second-tier district councils – coupled with the imposition of elected mayors, particularly in conurbations such as Greater Manchester.
