CAN THEY GET ALONG WITHOUT US - SUSTAINABILITY OF DONOR-SUPPORTED HEALTH PROJECTS IN CENTRAL-AMERICA AND AFRICA
CAN THEY GET ALONG WITHOUT US - SUSTAINABILITY OF DONOR-SUPPORTED HEALTH PROJECTS IN CENTRAL-AMERICA AND AFRICA
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DOI：
10.1016/0277-9536(90)90148-l
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发表时间：
1990-01-01
影响因子：
5.4
通讯作者：
BOSSERT, TJ
中科院分区：
文献类型：
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作者：
BOSSERT, TJ
本文介绍了美国政府资助的卫生项目在中美洲和非洲的可持续性的五个国家的研究的综合。这些研究采用比较框架审查了保健项目，以确定哪些项目活动在捐助者停止供资后仍在继续。这次审查发现，非洲的保健项目不如中美洲的保健项目那么稳固。这些研究随后评价了与项目可持续性有关的背景因素和项目特点，发现非洲国家薄弱的经济和政治背景阻碍了这些国家的可持续性，这表明，在捐助者期望非洲保健项目具有显著的可持续性之前，应先解决更广泛的发展问题。即使在中美洲，人们也发现，执行项目的机构的实力是可持续性的一个重要变量，这表明捐助者的注意力也应该转向加强机构发展，以确保可持续性，除了背景因素外，在大多数情况下，若干项目特点与可持续性有关，并为项目设计和执行提出了可持续性准则。文章的结论是，项目的设计和管理应：（1）在实现明确界定的目标和目的方面显示出有效性;（2）将其活动充分纳入既定的行政结构;（3）从国家来源获得大量资金（4）以相互尊重的互让过程谈判项目设计;（5）包括一个强有力的培训部分。
This article presents a synthesis of five country studies of the sustainability of U.S. government-funded health projects in Central America and Africa. The studies reviewed health projects with a comparative framework to determine which project activities had continued after the donor funding ceased. This review found that health projects in Africa were less firmly sustained than those in Central America. The studies then evaluated context factors and project characteristics that were related to the sustainability of the projects.The weak economic and political context of the African cases was found to inhibit sustainability in those countries, suggesting that broader development issues be addressed before donors expect significant sustainability of health projects in Africa. Even in Central America it was found that the strength of the institution implementing the project was an important variable for sustainability, suggesting that donor attention also be shifted toward strengthening institutional development in order to assure sustainability.In addition to context factors, several project characteristics were related to sustainability in most cases and suggest sustainability guidelines for project design and implementation. The article concludes that projects should be designed and managed so as to: (1) demonstrate effectiveness in reaching clearly defined goals and objectives; (2) integrate their activities fully into established administrative structures; (3) gain significant levels of funding from national sources (budgetary and cost-recovery) during the life of the project; (4) negotiate project design with a mutually respectful process of give and take; and (5) include a strong training component.