Attention to the sustainability of health intervention programs both in the US and abroad is increasing, but little consensus exists on the conceptual and operational definitions of sustainability. Moreover, an empirical knowledge base about the determinants of sustainability is still at an early stage. Planning for sustainability requires, first, a clear understanding of the concept of sustainability and operational indicators that may be used in monitoring sustainability over time. Important categories of indicators include: (1) maintenance of health benefits achieved through an initial program, (2) level of institutionalization of a program within an organization and (3) measures of capacity building in the recipient community. Second, planning for sustainability requires the use of programmatic approaches and strategies that favor long-term program maintenance. We suggest that the potential influences on sustainability may derive from three major groups of factors: (1) project design and implementation factors, (2) factors within the organizational setting, and (3) factors in the broader community environment. Future efforts to develop sustainable health intervention programs in communities can build on the concepts and strategies proposed here.
PIP: Many community-based health programs implemented in developing countries around the world are discontinued soon after initial funding ends. Attention to the sustainability of health intervention programs in the US and abroad has increased in recent years as policymakers and funders become ever more concerned with allocating scarce resources effectively and efficiently. There is, however, little consensus upon the conceptual and operational definitions of sustainability. Planning for program sustainability requires a clear understanding of the concept of sustainability and operational indicators which can be used to monitor sustainability over time, as well as the use of programmatic approaches and strategies which favor long-term program maintenance. Potential influences upon sustainability may derive from the following factors: project design and implementation factors, factors in the organizational setting, and factors in the broader community environment.