Research by Khanya on 'Institutional Support for Sustainable Livelihoods in Southern Africa' in 2000 has shown that if livelihoods of poor people are to improve, it is critical to improve the linkages between micro level (community) and meso level (local government and district service providers). Much participatory work has exposed how poor people actually depend on community-based services, ranging from traditional healers, local creches, local shops, rather than government services. The one notable exception is the primary school, which is ubiquitous.

Decentralisation is being advocated as one of the answers to pro-poor service delivery. However one of the limiting factors is that work on strengthening local government and other government agencies has often not succeeded in strengthening the links between these agencies and citizens. Similarly attempts at sectoral reform have often not resulted in services reaching communities, except in innovative approaches adopted by some NGOs. Increasingly alternative service models are being adopted in sectors such as HIV, where conventional models cannot cope with the scale of the need.

The Community-Based Worker (CBW) project focuses on promoting dispersed, active and locally accountable community workers, who can work in a range of sectors, addressing services which are needed very frequently and so are best delivered locally. Current examples include paravets, community health workers, paralegals, home-based care workers, tutor farmers. These may work from 3-20 hours per week, and range from volunteers to paid staff. They form part of a system and the CBWs need to be supported by a facilitating agent providing support and supervision, who could be from government, NGOs or the private sector, as well as specialist service providers. Typically the system may be funded by government, although in some cases it can be privately funded (as with paravets in some cases).