Sustainability of Health Assistance

Abstract

AbstractThis chapter aims to provide an empirical operationalization and conceptual definition of sustainability in the context of health aid. Based on an overview of the literature on health interventions, it adapts and extends the existing frameworks to provide a comprehensive basis for analyzing this phenomenon. As sustainability may have diverse and, at times, contradictory connotations for different stakeholders, this chapter encourages a precise empirical operationalization of this term, following Iwelunmor et al. (Implementation Science, 11, 1–27, 2016). Conceptually, this chapter adopts Shediac-Rizkallah and Bone’s (Health Education Research, 13, 87–108, 1998) definition of sustainability as maintaining benefits, continuity of project activities, and building the capacity of a recipient community but extends it by further clarifying “community” and “capacity-building.” To this end, it builds on the works of Labonte and Laverack (Critical Public Health, 11(2), 111–127, 2001a, Critical Public Health, 11(2), 129–138, 2001b) and insights the author of this book gained during her fieldwork in the Kyrgyz Republic. Furthermore, acknowledging the high level of uncertainty associated with the assessment of sustainability, this chapter outlines the critical factors associated with the sustainability of health aid. These are financing; the political and economic situation in the recipient country; historical, systemic, and cultural factors pertinent to the context; and organizational factors related to the health intervention itself.