Most program directors I have met at Ministries of Health often ask me: How can we sustain progress made by (usually a donor-funded project or organization) and keep moving forward?
Good question. When “sustainability” came into the equation with the approval of the “Sustainable Development Goals” in 2015, the way we work in Global Health started to change. Measures of aid effectiveness are now becoming common practice in several organizations working in global health. It is no longer enough to do good work, but it also has to last. It is important now to ensure that what a global health project does is not only adopted by “Host” countries but also owned, sustained and scaled-up to the rest of the country.
The way to do sustainable work is to focus our work on strengthening the country’s health system. That means projects need to be adjusted to ensure all they do contributes to improve the country’s program and how the health system delivers healthcare. For example, a donor funding a project to improve family planning must only ensure that contraceptives are delivered and more couples are protected, but must ensure that the project improves how the country’s family planning program performs and how the public and private (for and non-profit) deliver family planning services so they can continue to do so AFTER the project ends.
In short, just remember the RGH development sequence: “Project-Program-System.” The sequence means that a project’s activities must improve and contribute to the corresponding program and implement changes that improve how the health system performs and delivers services. Here is another example, a donor interested in assisting a country to improve the Maternal and Child Health, TB, Malaria or Ebola programs, must ensure that the project contributes to what the Ministry of Health is doing to implement the Maternal and Child Health, TB, Malaria or Ebola programs, and contributes to improve what the health system does to deliver Maternal and Child Health, TB, Malaria or Ebola services.
More on health systems strengthening in the next blog. Listen to this week’s podcast and follow the upcoming series of podcasts on how to improve health systems in developing countries. To learn more about “Project-Program-System” and how we work at RGH to strengthen health systems, you might also want to try our free online training program.
