title: The size, characteristics and partnership networks of the health-related non-profit sector in three regions of South Africa: implications of changing primary health care policy for community-based care.
abstract: BACKGROUND
  Health-related community-based care in South Africa is mostly provided through non-profit organizations (NPOs), but little is known about the sector. In the light of emerging government policy on greater formalization of community-based care in South Africa, this article assesses the size, characteristics and partnership networks of health-related NPOs in three South African communities and explores implications of changing primary health care policy for this sector.
  
  
  METHODS
  Data were collected (2009-11) from three sites: Khayelitsha (urban), Botshabelo (semi-rural) and Bushbuckridge (semi/deep rural). Separate data sources were used to identify all health-related NPOs in the sites. Key characteristics of identified NPOs were gathered using a standardized tool. A typology of NPOs was developed combining level of resources (well, moderate, poor) and orientation of activities ('Direct service', 'Developmental' and/or 'Activist'). Network analysis was performed to establish degree and density of partnerships among NPOs.
  
  
  RESULTS
  The 138 NPOs (n = 56 in Khayelitsha, n = 47 in Bushbuckridge; n = 35 in Botshabelo) were mostly local community-based organizations (CBOs). The main NPO orientation was 'Direct service' (n = 120, 87%). Well- and moderately resourced NPOs were successful at combining orientations. Most organizations with an 'Activist' orientation were urban. No poorly resourced organizations had this orientation. Well-resourced organizations with an 'Activist' orientation were highly connected in Khayelitsha NPO networks, while poorly resourced CBOs were marginalized. A contrasting picture emerged in Botshabelo where CBOs were highly connected. Networks in Bushbuckridge were fragmented and linear.
  
  
  CONCLUSIONS
  The NPO sector varies geographically in numbers, resources, orientation of activities and partnership networks. NPOs may perform important developmental roles and strong potential for social capital may reside in organizational networks operating in otherwise impoverished environments. A uniform approach to policy implementation may not accommodate variations in the NPO sector. Considerations for adaptation may be necessary in light of the observed differences between urban and rural settings.
authors: Centre for Higher Education Development, University of Cape Town, Rondebosch, 7701, South Africa, Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, School of Public Health, University of Witwatersrand, Johannesburg and Earth Institute, Columbia University, NYC and School of Public Health, University of the Western Cape, South Africa ermien.vanpletzen@uct.ac.za.
authors: Ermien
authors: E
authors: van Pletzen
authors: Centre for Higher Education Development, University of Cape Town, Rondebosch, 7701, South Africa, Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, School of Public Health, University of Witwatersrand, Johannesburg and Earth Institute, Columbia University, NYC and School of Public Health, University of the Western Cape, South Africa.
authors: R
authors: R
authors: Zulliger
authors: Centre for Higher Education Development, University of Cape Town, Rondebosch, 7701, South Africa, Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, School of Public Health, University of Witwatersrand, Johannesburg and Earth Institute, Columbia University, NYC and School of Public Health, University of the Western Cape, South Africa.
authors: M
authors: M
authors: Moshabela
authors: Centre for Higher Education Development, University of Cape Town, Rondebosch, 7701, South Africa, Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, School of Public Health, University of Witwatersrand, Johannesburg and Earth Institute, Columbia University, NYC and School of Public Health, University of the Western Cape, South Africa.
authors: H
authors: H
authors: Schneider
mesh_terms: D003153:Community Health Services / Q000458:organization & administration*; D006291:Health Policy; D006296:Health Services; D006801:Humans; D009939:Organizations, Nonprofit / Q000458:organization & administration; D011320:Primary Health Care / Q000458:organization & administration*; D036301:Qualitative Research; D012424:Rural Population; D013019:South Africa
keywords: Health-related non-profit organizations; South Africa; community-based care; policy on primary health care