| Leadership | High-level leaders must accept that the transition process is actually occurring, and health sector leaders need to provide political support for transition and for sustaining the program in its new environment post-transition. Political will and commitment are complex and context-specific and need to be built beyond individual leaders, who may be transient. High-level leadership needs to come from both within the health sector and from non-health sector actors, such as the Ministry of Finance. |
| Financing | In order to ensure financial sustainability post-transition, the program recipient will need to identify and secure new sources of funding as prior sources of financial support are eliminated. Funding will likely come from multiple sources, and, as such, activities may include lobbying to secure funding from new sources and creating and altering financial mechanisms for improved sustainability. |
| Programming | Responsibilities for program management, such as day-to-day operations, as well as staff management, funding, reporting requirements, monitoring and evaluation, and other administrative tasks, must be transitioned, to the extent that such functions were previously provided by donors. Capacity assessments can help diagnose competencies and signal the amount of capacity building and training required to transition programming. |
| Service delivery | In instances where donors, and not local organizations, have been directly responsible for service delivery, the local program recipient may have to take responsibility for the logistics of service delivery, including human resources, commodity procurement, community outreach, and other elements related to the program services itself. |