title: Development of non-profit organisations providing health and social services in rural South Africa: a three-year longitudinal study.
abstract: BACKGROUND
  In an effort to increase understanding of formation of the community and home-based care economy in South Africa, we investigated the origin and development of non-profit organisations (NPOs) providing home- and community-based care for health and social services in a remote rural area of South Africa.
  
  
  METHODS
  Over a three-year period (2010-12), we identified and tracked all NPOs providing health care and social services in Bushbuckridge sub-district through the use of local government records, snowballing techniques, and attendance at NPO networking meetings--recording both existing and new NPOs. NPO founders and managers were interviewed in face-to-face in-depth interviews, and their organisational records were reviewed.
  
  
  RESULTS
  Forty-seven NPOs were formed prior to the study period, and 14 during the study period--six in 2010, six in 2011 and two in 2012, while four ceased operation, representing a 22% growth in the number of NPOs during the study period. Histories of NPOs showed a steady rise in the NPO formation over a 20-year period, from one (1991-1995) to 12 (1996-2000), 16 (2001-2005) and 24 (2006-2010) new organisations formed in each period. Furthermore, the histories of formation revealed three predominant milestones--loose association, formal formation and finally registration. Just over one quarter (28%) of NPOs emerged from a long-standing community based programme of 'care groups' of women. Founders of NPOs were mostly women (62%), with either a religious motivation or a nursing background, but occasionally had an entrepreneurial profile.
  
  
  CONCLUSIONS
  We observed rapid growth of the NPO sector providing community based health and social services. Women dominated the rural NPO sector, which is being seen as creating occupation and employment opportunities. The implications of this growth in the NPO sector providing community based health and social services needs to be further explored and suggests the need for greater coordination and possibly regulation.
authors.affiliation: School of Public Health, University of Witwatersrand, Johannesburg, South Africa ; Rural AIDS and Development Action Research, University of Witwatersrand, Acornhoek, South Africa.
authors.forename: Mosa
authors.initials: M
authors.lastname: Moshabela
authors.affiliation: Geneva Global, Wayne, Philadelphia, Pennsylvania, United States of America.
authors.forename: Shira
authors.initials: S
authors.lastname: Gitomer
authors.affiliation: Rural AIDS and Development Action Research, University of Witwatersrand, Acornhoek, South Africa.
authors.forename: Bongiwe
authors.initials: B
authors.lastname: Qhibi
authors.affiliation: School of Public Health, University of the Western Cape, Cape Town, South Africa.
authors.forename: Helen
authors.initials: H
authors.lastname: Schneider
mesh_terms: D003153:Community Health Services; D003695:Delivery of Health Care; D005260:Female; D006296:Health Services; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009939:Organizations, Nonprofit; D012424:Rural Population; D012947:Social Work; D013019:South Africa