Sustainability Strategy. CSRA defines sustainability as follows: A sustainable local health system is the continuous, indefinite provision of benefits (quality health services) to defined communities. CSRA has learned that sustainability ensues only if the following elements are in place: sufficient and secure provision of resources; offering products that are in demand; good technical capacity; an organizational structure that guarantees accountability, clear goals and objectives, values, and a stable work environment; and leadership that foresees and prepares for the future, motivates people and fosters a sense of ownership. Sustainability strategies in the CSXIII Project were implemented in three main areas: financial sustainability, institutional sustainability, and coordination with other institutions and municipal governments. Results from the sustainability strategy implemented during the CSXIII Project are impressive. Following is a brief summary of achievements. ❑ Increase local support for recurrent costs of health facility management from 18% to 50%. LOCAL SUPPORT FOR RECURRENT COSTS Geographic Area Baseline 1996-1997 Percent Local Support Final 2000-2001 Percent of local support Total Operational Budget Local Support Total Operational Budget Local Support Carabuco $120,867 $22,787 19% $152,201 $82,807 54% Ancoraimes $135,874 $27,801 20% $147,252 $50,519 34% Puerto Xxxxxx $69,094 $16,305 23% $152,568 $58,504 38% ❑ Increase the proportion of resources generated by CSRA (not counting support from Curamericas) from 34% to 67% of the budget. Information from 2001 for Carabuco, Ancoraimes and Puerto Xxxxxx, and estimates from CSRA Offices in Montero and La Paz, shows that CSRA is currently generating 59% of its budget, an increase from $519,113 to $876,706 over a four year period. ❑ Include salaries for staff positions created by the CSXIII Project in the annual MOH budget. All positions created during CSXIII have received official MOH endorsement and are now budgeted annually by the MOH for the project target area. MOH salaried staff slots increased from 23 to 35, and positions sponsored by municipal governments increased from 3 to 8. ❑ Increase sales by 25% in CSRA/MOH operated health facilities (Ancoraimes, Carabuco, Puerto Xxxxxx). INCREASE IN SALES FOR CS XIII TARGET AREAS Carabuco $3,862 $7,682 99% Ancoraimes $7,939 $13,550 71% Puerto Xxxxxx $1,527 $11,295 640% ❑ Maintain rotating drug funds. Rotating drug funds have been maintained in all three Area Health Facilities....
Sustainability Strategy. The DIP outlined a detailed devolution strategy that focused on how the MOH would take over responsibility for ongoing training and support of community activities. The plan did not really focus on the essential elements for supporting continued implementation of the desired behaviors at the household level. In addition, with a nearly complete turnover of staff since DIP development, it was relevant to revisit the plan for sustainability. This was done as the last step in developing the action plan. Three elements were defined that will determine project sustainability: the maintenance of the desired behaviors at the household level, the maintenance of community structures that support these behaviors, and the maintenance of health services at the health center that also support these behaviors. At the household level, the project objectives define the desired behaviors. It is unlikely these will be self-sustaining after the end of the project if the support services are not maintained. Support structures at the community level include the associations for the health volunteers, the mutuelle and health committees to help assure access to services, and supervision from the health centers for these activities. Brainstorming of sustainability indicators for these structures included: ▪ Associations and committees continue to meet independently without the activist ▪ Members of associations and committees are well trained, link with existing health structures, and have access to a minimal motivation system. ▪ Health center staff provide field supervision of community activities without project support. An intermediate indicator would be the health committee managing funds to support community activities – even if the funds are from the project. Continued access to services both in the community and at the health center are an essential element of maintaining the desired behaviors. Indicators suggested for these included: ▪ Purchasing and logistics systems in place through the District to assure essential supplies ▪ Regular supervision and quality improvement efforts without project support ▪ Ongoing provision of specific services according to care standards: VCT, PMTCT, pre-natal and post-partum care according to international standards, malaria treatment according to protocol, provision of modern family planning methods, growth monitoring with positive deviance sessions for malnourished children, and sale of impregnated bednets. The project will further consi...
Sustainability Strategy. In the context of the 2030 agenda for sustainable development, UNIDO aims to harness the full potential of the industry’s contribution to the achievement of sustainable development, and lasting prosperity for all. UNIDO interventions in this project are aligned with SDG-9 which acknowledges that innovation and industrialization are the main drivers of sustained economic growth, environmental sustainability and shared prosperity. The strategic alliance between Cuba and Slovenia in the designated priority sectors will be in line with UNIDO’s Medium Term Programme Framework (MTPF) for 2018 -2021, the Slovenian Cooperation agreement with UNIDO and the current UNIDO’s Country Programme for Cuba. Within this project, a feasibility study on the development of the innovation cluster of Slovenia and Cuba for the selected sectors will be performed, including the assessment of specific business options (for example generic product manufacturing, biopharmaceutical (biosimilar) manufacturing, distribution-focused entities, R&D), which also considers the pros and cons of each of these sub-sectors; and produce and action plan for the establishment of the cluster. These new products, technologies and processes developments identified within the cluster will have an impact on the human health and the quality of life, therefore the project also targets indirectly the SDG3 (good health and well-being). Moreover, the targeted sectors for this intervention have been prioritized within both countries´ updated industrial development strategies, and they have acquired even more relevance under the current COVID-19 pandemic crisis in: a) contributing to strengthen own countries capacities and international partnerships efforts in fighting the pandemic through the joint development of new treatments/ therapeutic vaccines, etc.; and b) accelerating the development of such new products / treatments, by bracing the Fourth Industrial Revolution (for example by assessing the use of AI and Big Data for reducing the clinical trials periods, or predicting product performance). The continuously growing market demand on new products/ services generated by the selected sectors combined with well stablished local capacities, enabling regulatory frameworks and policy incentives, and public health system’s needs and demands; make these sectors attractive enough for accessing to government support and gaining international/ local private investors interest as well. The development of the innovati...
Sustainability Strategy. Plan Cameroon’s Child Survival Project defined sustainability as the ability of communities to sustain health improvements and enhance the health system in the absence of a project team or external funding. The project is to be judged sustainable if:
1) the Community Resource Persons are responsive to the health needs of the community and provide quality services accordingly; and 2) a strong link is maintained between the community and health facilities through monthly outreach activities, quality health services, and functioning health committees. The sustainability plan envisaged the stimulation of community participation and ownership of preventive promotional health activities, improved quality of MOH health facilities and services and the putting in place of a viable financial system through cost recovery schemes. The first two components of the strategy have been attained to a large extent while financial sustainability is still rather weak. Community participation and ownership were strongly reinforced through empowerment by training of health committees and CBO members, TBAs and the health promoters who worked in close collaboration with frontline health staff to provide essential health services to the beneficiaries though outreach services. On their own, the community based resource persons (health committees, CBOs and TBAs) are continuing to raise awareness among community members on the key household and community practices that promote and enhance child health and survival. The CBOs active involvement in maternal and child health activities is an innovation that has been initiated by the CS project and it is showing promising signs of a lot of potential for success. The project trained 120 CBOs i.e. 3,600 members, more than 90 % of whom are women (mothers of under –fives inclusive) who are directly involved in child care. This explains their interest in child health issues. Plan has already obtained funding from Plan US national office to continue with CS activities for the next one year. Apart from this, Plan will continue to provide assistance to the MOH and other organized groups intervening in the health domain in the project zone even with core funds. Plan is also submitting a new proposal to USAID under the expanded impact category, which if granted, will enable scale up of IMCI in 11 health districts where Plan is undertaking integrated community development work in three provinces of the country. Plan is assisting CBOs to engage in inc...
Sustainability Strategy. Sustainability Objective End Results • 2 DHOs will prepare an annual health workplan indicating efficient use of resources. • 75% of CHTs at regulado level will attend meetings regularly. • 2 DHOs will have supervisory and monitoring systems for QOC and peer review. • DHOs will regularly share lessons learned at provincial and national MOH levels. • DHOs commit to sustaining CHT training and formation by inclusion into yearly DHO plans. The weaknesses of the capacity building assessment reflect on the potential sustainability of activities beyond the life of the project. Neither DDS had annual work plans or even quarterly work plans in addition to the SC training plans. Monitoring systems for health workers, quality control of services and for CLCS do not exist. It is necessary that districts and province commit time and resources to continue monitoring CLCS beyond the life of the project to keep them motivated. With the interest fostered by the MTE, we expect that the relationship of the DDS and CLCS to improve. District financial and budget management issues need to be addressed. The periodic unavailability of the MOH vehicles assigned to each district will further strain the ability to carry out supervisory activities. Finally a huge challenge is the destiny of the cars currently working in the districts. These two vehicles might not be kept in the districts after the end of the project and this is a major obstacle to continuation of activities. In order to ensure continuation of activities SC and DDS staff have to:
1. Institute the monthly meetings at district level and jointly plan and budget activities. This exercise for the remainder of the project will consolidate a management attitude adequate for sustainability purposes. An example could be:
a. Always start with a clear presentation of the project objectives and strategies to keep them in mind.
b. Data presentation by intervention area. Compare with last report. Discuss trends, why or why-nots of data, quality aspects. Ask justifications, teach data analysis, and stress formative character of meeting. Identify problems and problem-regulados. Discuss solutions; identify responsible, make clear guidelines and actions. Jot down to follow-up accomplishment in the next meeting. Be consistent and comprehensive.
c. Study DIP work plan and MTE Action Plan for activities that are planned for the period. Discuss with persons responsible, how to accomplish activities, spell out straight guidelines, and conf...
Sustainability Strategy. The Consortium’s goal is to achieve a quality-based sustainability plan that will allow FIPDes to be a world- class programme able to attract the best students, partners and employers. The strategy is based upon the following pillars: • innovative education content tailored on market’s needs • targeted dissemination and exploitation of results • strategic partnerships with socio-economic actors This will lead to secure excellent employability prospects. The FIPDes Programme will therefore be recognized as a brand of excellence at international level, facilitating fundraising. The sustainability plan implies financial and institutional objectives: • to deliver the FIPDes Joint degree within the expected timeframe by the Consortium (year 2021) • to ensure the highest HEIs commitment towards an optimised human resource management of the key staff in order to ensure a smooth and consistent management. The cost-effective organisation of the FIPDes Consortium will also support the FIPDes sustainability plan • to ensure that the students’ selection and recruitment process remain focussed on excellence • to increase progressively the number of self-paying students • to be able to raise funds and being 100% financially autonomous at the horizon 2021 • to xxxxxx excellent employability results. The Consortium undertakes to assure the dissemination and promotion of the Programme through the dedicated website (xxx.xxxxxx.xx), social networks, emailing, intern communication, etc. They commit to use the Erasmus + and the FIPDes logo systematically for the dissemination. All logos and guidelines regarding Erasmus+ are available here: xxxxx://xxxxx.xx.xxxxxx.xx/about-eacea/visual-identity_en
Sustainability Strategy. The Contractor shall ensure that the Sustainability Strategy: complies with all current and future Government Sustainable Development and Waste Management Policies and legislation; and sets out a strategy for meeting or improving on the targets set out in Greening Government Commitments. The Contractor’s Sustainability Strategy shall be appended at Schedule 24 (Sustainability Strategy).
Sustainability Strategy. The stated sustainability objectives for the project are as follows:
1. 100% of MOH staff trained in skills and concepts for effective Child Survival.
2. 100% of MOH staff using IMCI for assessing and diagnosing all children under five.
Sustainability Strategy. The stated sustainability objectives for the project are as follows: 4 USTF: Unidades de Salud Totalmente Funcionando (Health Units Totally Functioning) ❑ 100% of MOH staff trained in skills and concepts for effective Child Survival. ❑ 100% of MOH staff using IMCI for assessing and diagnosing all children under five. ❑ An effective supervision and self-supervision system in place for MOH staff and CHWs. ❑ MOH staff using antibiotics to treat less than 30% of ARI cases.5 ❑ The MOH central outreach team will be visiting each community every two months to provide immunizations, patient follow-up, growth monitoring, home visits, health education, CHW supervision and in-service training, and support to the community development committees. ❑ The MOH will have a long-term plan for supervising and training CHWs and BF counselors. ❑ The MOH will have adopted quality assurance as an integral part of operation. ❑ The MOH will have a long-term plan for assessing their own training needs and for in-service training. ❑ A referral-counter referral system will be functioning effectively between all CHWs and the health units. ❑ Seventy communities will have action plans and functioning CDCs.6 ❑ Seventy communities will have a functioning base house used by residents. ❑ Fifty percent of households will be participating in at least one of the food security activities: gardens, credit, or family budgeting. ❑ Seventy breastfeeding counselors will be functioning and breastfeeding support groups will be established in each community or barrio. ❑ A minimum of 70 CHWs will be conducting home visits and tracking health status of 30 families each, conducting growth monitoring, providing education and counseling, making referrals and following up on patients counter-referred. ❑ 25% of the CDCs will be planning and executing self-help projects related to health. CARE’s CS Project has made exemplary progress towards its sustainability indicators, the majority of which have been surpassed. All MOH staff has been trained in Child Survival and IMCI, a supervision system is in place, TQM has been institutionalized assuring continuity of planning, evaluation, training, information system management, and community outreach. The referral and counter referral system is up and running, and sufficient supplies of forms exist for the next 2 years. Over 80 communities have a functioning Base House, and the number of breastfeeding counselors (155), AIN monitors (148) and Base House operators (86) ...
Sustainability Strategy. The sustainability objectives for this project follow with results: • 50% of the nutrition status impact on % of all 6-35 month olds <-2Z WFA is sustained one year after the end of Hearth sessions. This objective was met, although the high drop-out rate in the Red Azanake and the small numbers of children in some of the communities make it difficult to draw any solid conclusions. In the Red Norte, improvements were sustained and even surpassed over a year following the end of Hearth sessions. In the Red Azanake, improvements were not sustained one year following Hearth sessions; they reverted back to baseline rates. In Huanuni, they did not have the data to analyze whether improvements were sustained one year after implementation of Hearth sessions. They did, however, show that nutritional status improved in eight out of fourteen communities in which H/PD was implemented (see Results of cross-cutting approaches section for more details). APROSAR is committed to continuing to work on developing the H/PD methodology as they have seen improvements and believe that if they implement it in a manner more suitable to Bolivia, they could increase its impact. Still, H/PD remains, at least for now, the most intensive and expensive of the three approaches and for it to be a viable strategy to recommend for expansion, more fieldwork is needed to refine it and ensure that it can be effective in the challenging conditions in rural Bolivia. Positive deviance inquiry can be applied in many ways and in programs outside of the health sector, such as SC/B’s work in Education looking at positive deviant schools. APROSAR has also recognized this potential and plans to continue to use the approach in some of its other programs. • MOH or other PVO/NGO has written plans for implementation of SECI and/or H/PD in two other health districts. CB-IMCI is a national strategy that will continue beyond the Wawa Sana project as long as Promoters continue to work. Similarly, those Promoters who continue to work and who have been trained in and using SECI are likely to continue it (if health providers continue) because of high community demand. The evaluation team estimates that approximately 60% of Promoters will continue to work based on expressed interest and previous experience. However, whether they continue depends on the support they receive from the health providers and their communities and municipalities. Some encouraging signs include: 1) Wawa Sana instituted an accreditation pro...
