Sustainability of a community-based mother-to-mother support project in the peri-urban areas of Guatemala City : a La Leche League study

(1) In what sense has the program been sustained during the postgrant period (1993-96)? (2) What factors have contributed to its sustainability? (3) Can La Leche League International establish norms to ensure the sustainability of its program? The data show that the project has been sustained at nearly the same level as during the grant period. Although fewer trained breastfeeding counselors are reporting to LLLG or running support groups, they continue to give individual counseling and refer mothers and children to clinics. Key factors in this success are high personal motivation of various participants in the project and the six-level support structure that provides bidirectional support and motivation across the levels. The participation and decision-making at the community level and monthly and annual workshops and refresher training are other vital elements for sustaining the program. Other key observations are (1) the prominent perceived need by community women is physical and economic survival -- not health; and (2) coordination with the local health system is valuable and needs further development. (Author abstract)