Sustainability is the capability of a community to continue the programmes and remain reactive to change after the termination of external assistance. Many community development institutions remain active only while they are supported by external agencies. Hence there is huge dependency among community-based health and development institutions. They are not organisationally independent and financially viable while they are sustained by international support agencies in one way or the other. However Karim Sahyoun (see link below) suggests that development institutions can make a positive contribution without becoming totally dependent on outside help. He states that local community participation with clear ownership, commitment and enhanced capacity may prevent dependency. In this context, sustainability can be considered as the ability of the local institutions to maintain and continue the programmes incepted by international development agencies without interference by such external agencies.
Dr Emelita Santos Goddard claims that it is important to have a shared vision and plan for community-based development interventions to be sustainable (follow link below). Being fully dependent on outside charity does not promote sustainability. She suggests that sustainability is achieved when development initiatives and interventions are owned and managed by local people. Hence shared vision, local participation, authentic institutional partnership between support agencies and local implementing organisations, and a clear plan for local handover and continued encouragement are the keys to sustainability. In many cases, partnership has been focused on project funding systems, as donors give grants and in return recipient organisations provide reports. However, a partnership between agencies, based on a mutually binding covenant relationship goes far beyond project-based funding contract that has reciprocal relationship and mutual understanding on long-term sustainability of programmes.
Enhanced capacity and reinforced confidence of community-based institutions and individuals are vital for sustainable development. In order to implement a strategy of sustainability, the community must believe that they are capable of solving their problems and shaping their own future. Engaging stakeholders in all stages of development process and creating a network and extending cooperation among likeminded individuals and institutions locally and internationally are equally important. It is also sensible to have a very strong core group of individuals, who are guided by a shared vision and have strong desire to run the programmes, and the organisation is positioned in strong values. The following steps are the key to achieve sustainable community health and development:
- Identify stakeholders and get their agreement on programme implementation
- Conduct a participatory community assessment
- Perform community organisation and raise awareness
- Create a community vision and develop a roadmap for reaching that vision
- Develop sustainability indicators to measure progress
- Introduce organisational development practices
- Run training and capacity building activities
- Identify sources of assistance and mobilize resources
- Carry out regular monitoring and evaluation
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