Original Research

Evaluating the sustainability of health programmes: A literature review

Foluso Ishola, Jindra Cekan
African Evaluation Journal | Vol 7, No 1 | a369 | DOI: https://doi.org/10.4102/aej.v7i1.369 | © 2019 Foluso Ishola, Jindra Cekan | This work is licensed under CC Attribution 4.0
Submitted: 29 January 2019 | Published: 18 July 2019

About the author(s)

Foluso Ishola, Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada; and, Institute for Health and Social Policy, Meredith Charles House, Quebec, Canada
Jindra Cekan, Valuing Voices, Cekan Consulting LLC, Washington, DC, United States

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Background: Evidence shows that fewer than 1% of all international development projects worldwide, including those in Nigeria, were evaluated at least 2 years after completion to learn what genuinely changed. With over 787 million US Dollars in official development assistance to Nigeria’s health sector in 2017, this seeming disinterest in assessing sustainability – particularly in light of the international commitments to the Sustainable Development Goals – is concerning.

Objectives: We aim to assess the overall body of knowledge on the evaluation of sustainability of health programmes in Nigeria.

Methods: We conducted a broad literature search, which included grey literature such as development project reports to identify all relevant studies reporting on our study objective. Articles were selected for inclusion using predefined criteria and data were extracted onto a purposely designed data extraction form.

Results: Four articles met our search criteria. The review identified financial, technical, social and environmental barriers to sustainability. Recommendations encompassed all stages of the project cycle: funding, design, implementation, monitoring and evaluation.

Conclusion: This review explored the overall body of knowledge on the evaluation of sustainability for health programmes in Nigeria. A clear understanding of operational indicators for sustainability, embedding sustainability early in the project cycle, community ownership, capacity building, effective collaboration, leadership and quality post evaluation are key for sustainable development in Nigeria. A limitation of this review is the small number of studies included and the assessment of sustainability at a single point in time. Much more empirical and rigorous research is needed to explore sustainability of health programmes in Nigeria. Research should also seek to understand the views of key stakeholders such as donors, implementing partners and the government.


sustainability; sustainable development; accountability; aid effectiveness; post-project evaluation; impact evaluation; funding; health programmes; Nigeria


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