Child survival projects in Bolivia and Bangladesh from 1985-1997 : what"s left after all these years?

The study focuses on the sustainability of financial/service delivery, technical and managerial capacity, community support, and benefit/impact. The sustainability of the child survival projects reviewed in both countries was found to be strong, with many project activities continuing even as long as 10 years after the cessation of USAID funding. The capacity built through the child survival process resulted in PVOs beginning activities in new countries, a new NGO being created, and strengthened monitoring and evaluation and other activities within both PVOs receiving grants and other PVOs/NGOs throughout the two countries. In addition, lessons learned became institutionalized as part of national policies and strategies within each country"s Ministry of Health (MOH). Community organizations continued to meet and volunteer health workers continued to work in the former project areas of six of the 13 PVOs/NGOs. Community surveys demonstrated that some PVOs sustained impact in communities from 2 to more than 4 years after the activities they had initiated had been discontinued. National policies and the relative stability and economic development of the country were found to affect the pattern of sustainability in each country, with more organizations continuing service delivery after USAID funding ended in Bangladesh and stronger examples of increased technical and managerial capacity in Bolivia. Through the PROCOSI (Programa de Coordinacion en Salud Integral) Network, PVOs/NGOs were better able to disseminate lessons learned to non-grant recipients and to the MOH. The report describes how some organizations were able to demonstrate the continued impact of their programs and suggests ways in which USAID may better institutionalize the measurement of sustainability within the grants program. (Author abstract, modified)