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An estimated 10.8 million children under 5 continue to die each year in developing countries from causes easily treatable or preventable. Non governmental organizations (NGOs) are frontline implementers of low-cost and effective child health interventions, but their progress toward sustainable child health gains is a challenge to evaluate. This paper(More)
Sustainability continues to be a serious concern for Primary Health Care (PHC) interventions targeting the death of millions of children in developing countries each year. Our work with over 30 Non-Governmental Organizations (NGOs) implementing USAID's Child Survival and Health Grants Program (CSHGP)-funded projects revealed the need for a study to develop(More)
Sustainability is a critical determinant of scale and impact of health sector development assistance programs. Working with USAID/Nepal implementing partners, we adapted a sustainability assessment framework to help USAID test how an evaluation tool could inform its health portfolio management. The essential first process step was to define the boundaries(More)
BACKGROUND The Kabeho Mwana project (2006-2011) supported the Rwanda Ministry of Health (MOH) in scaling up integrated community case management (iCCM) of childhood illness in 6 of Rwanda's 30 districts. The project trained and equipped community health workers (CHWs) according to national guidelines. In project districts, Kabeho Mwana staff also trained(More)
The pursuit of the Millennium Development Goals and advancing the 'global health agenda' demand the achievement of health impact at scale through efficient investments. We have previously offered that sustainability-a necessary condition for successful expansion of programmes-can be addressed in practical terms. Based on benchmarks from actual child(More)
Expansion of community health services in Rwanda has come with the national scale up of integrated Community Case Management (iCCM) of malaria, pneumonia and diarrhea. We used a sustainability assessment framework as part of a large-scale project evaluation to identify factors affecting iCCM sustainability (2011). We then (2012) used causal-loop analysis to(More)
BACKGROUND Starting in 1999, Concern Worldwide Inc. (Concern) worked with two Bangladeshi municipal health departments to support delivery of maternal and child health preventive services. A mid-term evaluation identified sustainability challenges. Concern relied on systems thinking implicitly to re-prioritize sustainability, but stakeholders also required(More)
After making large investments to put in place effective health and nutrition interventions, researchers, program implementers, policy makers, and donors all expect lasting effects. However, it is uncertain whether this is the case, and there is less certainty on how to approach the study of program sustainability. This symposium, "Building Evidence for(More)
We believe that global health practice and evaluation operate with misleading assumptions about lack of reliability of small population-based health surveys (district level and below), leading managers and decision-makers to under-use this valuable information and programmatic tool and to rely on health information from large national surveys when neither(More)
The right and responsibility of communities to participate in health service delivery was enshrined in the 1978 Alma Ata declaration [1] and continues to feature centrally in health systems debates today. Communities are a vital part of people-centred health systems [2, 3] and their engagement is critical to realizing the diverse health targets prioritised(More)