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Table 3 Advantages and disadvantages of DOH and NGO models of provision

From: The challenges of reshaping disease specific and care oriented community based services towards comprehensive goals: a situation appraisal in the Western Cape Province, South Africa

DOH provision NGO provision
Advantages Disadvantages Advantages Disadvantages
• financial security • CHWs easily become facility based • aligns with NHI contracting models • variable supervision and capacity
• personal job security • curative oriented • more responsive, innovative and efficient • power dynamic between DOH and NGO unequal
• career paths & promotion • barriers to entry, some excluded • community ownership & identity • CBS may not be their primary activity
• standardisation of roles • massively increase the costs • inter-sectoral action more feasible • funding streams vulnerable in the current financial climate.
• easier to control • CHWs would lose their community identify • primary prevention focus  
• better access to resources and supplies • advocacy for particular issues
• continuity of care & integration • history, credibility, & networks
• better alignment with the DoH outcomes
• lower transaction costs in managing contracts
• in-service training is easier