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Care farming is a promising example of multifunctional agriculture: it is an innovation at the crossroads of the agricultural and healthcare sectors. Our objective is to develop a framework for understanding the success of initiatives in this field. We link empirical data with the multi-level perspective from the transition sciences and extend this perspective with insights from the literature on entrepreneurship, alliance management and organisational attributes. This framework allows us to explain the success of the three major types of initiatives: (1) individual care farms; (2) regional foundations of care farmers; and (3) care institutions collaborating with groups of farmers at a regional level. We propose that the main factors responsible for the success of initiatives are the commitment and competences of the entrepreneur, the creation of alliances, the quality of the new regional organisations and the implementation of the care farm services in care organisations. The relative importance of the factors varies between the different types of initiatives and local and regional levels.

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Surveys among care farmers and data from the National Agricultural Census were analysed to describe the care-farming sector in the Netherlands. The number of care farms increased from 75 in 1998 to 591 in 2005. Care farming is the fastest growing sector of multifunctional agriculture. In 2005, nearly IO,OOO clients made use of care farms, of which 8000 used non-institutional care farms. The main client groups were mentally challenged clients, psychiatric clients, autistic persons, elderly people and youths. The average annual revenue of care activities on a non-institutional care farm was about € 73,000, which amounts to annual revenues of € 37.1 million for the total Dutch non-institutional care-farming sector. The annual revenue for care activities was considerably higher than for other extended activities. Care farming resulted in 473 additional jobs in 2005. The prospects of care farming are positive and the growth in number of care farms is expected to continue.