Sustainability Framework Overview


The Sustainability Framework (SF) is a way to organize thinking about sustainability as well as inform planning, management, and evaluation of activities in order to improve and maintain health outcomes at a population level. The SF is implemented by project staff and local stakeholders.

Taking the Long View Sustainability Manual

The Taking the Long View manual was designed to assist project managers, planners, and evaluators in their efforts to improve their approaches to planning for and assessing sustainability in health projects implemented in developing countries. The manual represents the collective learning of about 30 projects that have applied and helped refine it over a 7-year period, many of them CSHGP-funded projects.

Taking the Long View manual (PDF, 1.87 MB)  Cover (PDF, 0.79 MB)  |   Annexes (PDF, 2.93 MB) Cover (PDF, 0.33 MB)

Sustainability Assessment Steps

The assessment steps for project planning are discussed below.


Sustainability Assessment Steps for Project Planning

Step 1: Define the local system to be assessed. Who - which stakeholders - needs to be at the table to define and pursue a common long-term vision?

"Local system" refers to the local stakeholders and communities brought together to map out their vision and goals for sustained health improvement in the community. Local system also defines the level at which evaluation can take place in a meaningful way. Examples of stakeholders in the local system include villages, women's associations, local authorities, rural development associations, health district and health posts, local socially active NGOs, and private sector partners.

Sustainability planning must begin with understanding what the local system is. In fact, as the project interacts with stakeholders, it also can help better define this local system. Starting to draw a simple Venn diagram as a team is a simple way to start thinking about this local system. Within the circle of the Venn diagram belong all the actors (stakeholders) in the local system. Outside the circle you can write in those key organizations that influence the actors in the local system. The initial stakeholder analysis should be broad and wide-ranging; however, this does not mean that all identified stakeholders will be equally important or involved. Managers must sort stakeholders by their appropriate level of engagement, focusing the majority of energy on those stakeholders that are the most influential and interested in the vision of improving health.

See Section 2.1, page 23 and Annex 2.2 of the Taking the Long View manual for more information.

Step 2: Define the sustainability scenario of the local system for achieving its vision. Identify the elements of the Sustainability Framework, which will need to be in place to advance this scenario.

Health Outcomes

The sustainability scenario is a short description of how the local system can expect to achieve and maintain its vision in the long term. It broadly identifies the roles and responsibilities of stakeholders, the capabilities they need to have to fulfill these roles, the flows of inputs needed, and the attributes of an environment that would be properly supportive. The sustainability scenario is not an operational plan, but rather presents the big picture in terms of roles and essential components of capable and viable key partners in a local system producing an adequate level of health in the population.

See Section 2.1, page 26 and Annex 2.3 of the Taking the Long View manual for more information.

Step 3: Choose or construct indicators to assess the status of the system in relation to its scenario. Organize indicators or create indices as required to summarize progress on the different components of evaluation.

The Sustainability Framework is both a process and the content resulting from this process. Different dimensions of progress (outcomes, capacity areas, environment, etc.) are presented as Components of the Sustainability Framework. Each of these components includes many Elements to which indicators are attached. Indicators are frequently transformed and computed into index values for each component and presented visually to guide analysis and decisions.

See Section 2.1, page 28 and Annex 2.3 of the Taking the Long View manual for more information.

Step 4: Develop an assessment plan, and measure the value of the indicators for each component of the Sustainability Framework.

After defining/mapping the local system and developing a shared vision, stakeholders should carry out a set of assessments to determine baseline attainment of each of the six measurement components of the SF to find out where they stand at present.

See Section 2.1, page 29 and Annex 3 of the Taking the Long View manual for more information.

Step 5: Present data

Data are usually presented on a radar diagram, showing the attainment of each of the components of the SF. Other representations are also possible. The point is to make the large amount data visually appealing and easily understandable. For the more qualitative aspects of the sustainability assessment, there are also notes to guide an evaluation effort.

See Section 2.1, page 29 and Annex 2.6 of the Taking the Long View manual for more information.

Step 6: Engage actors of the local system in reviewing results. Propose strategic interventions by actors of the system. Define or revise your project's strategy to better contribute to the local actors' plans.

The following activities are recommended to develop programmatic responses through a consensus process with key stakeholders:

  • Step 6a: Conduct environmental scan activity with stakeholders to look at barriers/facilitators to action outside the direct control of the local system. Consider whether any of the identified factors are amenable to improvement by local system stakeholders. Think about mitigating the effects of any others. See Annex 3, page 152.
  • Step 6b: Conduct a present/future reality analysis in order to develop or refine the sustainability scenario of the local system. See Annex 2.4.
  • Step 6c: Determine what your project can contribute to the vision/scenario by identifying priority activities. See Annex 2.4.
  • Step 6d: Develop your project Results Framework within a sustainability plan of the local system. See Annex 2.5.

See Section 2.1, page 30 of the Taking the Long View manual for more information.


Created with support from USAID's Maternal and Child Health Integrated Project (MCHIP)