Table 2. Summary of Empirical Inputs Into Framework .
| Source | Key Findings and Contributions |
| Provincial case study 1: North West20 |
• Early adopter and successful implementer of WBOT Strategy • Governance as managing change, including the importance of common collective visions, participatory planning and feedback mechanisms • Technical system (human resource, finance etc) reorganisations required for implementation • Community dialogues as key to implementation • The complexity of relationships between facility and community-based teams |
| Provincial case study 2: Western Cape21 |
• Well established pre-existing provincial model, with organisational resistance to new strategies • Reorientations in technical systems and local organisational relationships required to shift from disease specific to comprehensive approaches integrated into the PHC system • The importance of shifting managerial mind sets and styles in the PHC and district system from command and control to the more collaborative, horizontal approaches required to engage other players in community health systems • The role of priority setting and planning at sub-district level |
| Provincial case study 3: Gauteng22 |
• Traditions of innovative district-level community-based programmes having to negotiate the “fit” with the new national strategies • The value of independent physical locations (“health posts”) in enabling the autonomy of community-based teams from facility level demands • The mechanisms of community level inter-sectoral coordination |
| Cross case analysis8 | • Governance and leadership tasks in the above case studies synthesised into four key roles |
| National observations26 |
• Insufficient national political commitment identified as a key constraint to sustainable implementation at provincial and district level • Delays in finalising policy (expressed commitment) • Weak national planning and coordination mechanisms (institutional commitment) • Lack of ring fenced resources for expanded community-based services (budgetary commitment) • Little priority given to information and research on WBOTs |
Abbreviations: WBOTs, Ward Based Primary Health Care Outreach Teams; PHC, primary healthcare.