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Beatrice Rogers and JenniferCoateswith:Johanna Andrews, Alexander Blau, Ameya Bondre,Jamie Fierstein, Kathryn Houk, Tina G...
Exit Strategy StudyOverview2
Study Rationale3 Title II programs closing in non-prioritycountries Little systematic knowledge of whetherprogram impact...
Study Objectives41. Determine the extent to whichactivities, outcomes, and impactsof Title II programs weresustained.2. Id...
Key Concepts5 Sustainability Sustainability ofimpacts amongprogramparticipants Diffusion of impactsto new populations ...
Key Concepts: Exit Strategy/Sustainability Plan6 Explicit plan for transition from programsupport to exit Often called “...
Study Methods Overview71. Qualitative picture of exit strategy implementationaround time of agency exit2. Qualitative inqu...
Analytic Strategy: Associating ExitStrategy with Sustainability of Impacts8 Agency evaluations did not include controlgro...
Study Locations• Kenya• Bolivia• Honduras• IndiaSelection Criteria• Programs achieved keyimpacts on food security andmalnu...
ConceptualizingSustainability and Exit10Sustained ImpactSustained Behaviors and/orService UtilizationSUSTAINEDSERVICEDELIV...
11 Critical combination of resources, motivation, andtechnical and managerial/administrative capacity Programs should be...
RESULTS - BOLIVIA12
13Title II Program Areas in Bolivia
142002 20112008-9Agencies collectbaselinequantdataTuftscollectspost-programqualitativedata2010Tufts collectspost-programqu...
151. Maternal and Children Healthand Nutrition (MCHN)2. Water and Sanitation (WatSan)3. Agriculture/Rural IncomeGeneration...
16 Motivate CHWs to continue providing GMP, healthpromotion and home visits through social prestige andrespect; credentia...
17 Prevalence of stunting declinedsubstantially during Title II andgenerally remained low after exit: ADRA, CARE, SC: No...
18Departmental statistics (< 5y)Title II Communities (3–35 mo)Percentage of children stunted (HAZ)Stunting
19 GMP participation and prenatal care visits remained high Success of linkages to national government programs: Zero M...
20Percentage of households taking child < 5y to GMPGrowth Monitoring Participation
21Percentage of mothers reporting any prenatal care during last pregnancyPrenatal Care
22Percentage of mothers reporting prenatal care in first 5 months during lastpregnancyPrenatal Care (< 5mo)
23 Presence of a community healthworker remains high Coherent governmental and NGOinitiatives likely sustaining CHWprese...
24 FH collaborates with UNICEF insome former Title II communities inmalnutrition prevention and GMP,with funding from Spa...
25Percentage of communities reporting CHW presenceCommunity Health Workers (2011)
26 EBF increased during the program and hasbeen sustained No cost; reinforced bygov’tprograms(BJA, ZM) All other practi...
27Title II Communities National StatisticsPercentage of mothers reporting exclusive breastfeeding for child < 6moExclusive...
28Diarrhea Treatment (food andliquid)Percentage ofmothers offeringsame/more food tochild duringdiarrheaPercentage ofmother...
29Percentage of mothers offering same/more food , liquid, orORT to childduring last diarrhea episodeDiarrhea Treatment (fo...
30Percentage of children 12–23 months of age receiving the third dose of DPT orpentavalente vaccineNote: No data available...
31 Sustainability of impacts and CHW service use due toalignment with government health programs andpresence of NGOs for ...
32Piped waterand latrinesAwardee provided inputs for construction of piped waterand latrinesElected water committees tra...
33 Vertical linkages to municipal government and horizontallinkages among water committees were part ofsustainability pla...
34 Infrastructure continues to be available in Awardee areas Percentage of communities reporting piped water andlatrine ...
35Percentage of households with piped waterTitle II Communities Departmental StatisticsPiped Water
36Percentage of communities maintaining their own water system (2011)Water System Maintenance
37Percentage of households with latrineLatrine Access
38Percentage of population using hygienic sanitation facilities (with signs of use,Awardee criteria)Latrine Use
39Percentage of caregivers (responsible for food preparation) with properhandwashing practices (awardee criteria)Handwashi...
40Percentage of caregivers using soap/detergentNote: No data available for CARESoap Use
41Percentage of households using any water treatment (boiling, chlorination, SODIS)Note: No data available for FHWater Tre...
42 Water and sanitation infrastructure demonstrated greatersustainability than hygiene behaviors and waterpurification I...
WatSan Sustainability!43
44Rural Income Generation (RIG) ExitStrategy Model farmers were given free agricultural inputs andtraining in return for ...
45Results Rural Income Generation(RIG) Agricultural income of farmers increased throughout theprogram, but fell substanti...
46Mean Annual Income from Agricultural Sales by Farmers Trained in theProgram(adjusted for inflation, 2011=100)Agricultura...
47Mean Annual Agricultural Income: ProducerAssociation Members vs. Non-Members(2011)
48Percentage of trained farmers belonging to a producer associationNote: No endline data available for ADRA and FHCARE par...
49Percentage of trained farmers adopting improved agricultural practices(Awardee criteria)Improved Agricultural Practices
50 Percentage of farmers in producer associationsis declining Members of producer associations havesubstantially higher ...
51 Use of inputs and promoted practices declining Inputs provided free during life of program nowmust be purchased; farm...
52 Sales through an association more likely whereassociations continue to receive support from externalsources (NGOs, fou...
53 Practices have declined significantly since exit Food for work and free inputs no longer available Motivation is low...
54Trained Farmers Adopting at LeastThree NRM Practices
55 NRM activities largely not sustained after exit Technical capacity was strong; resources andmotivation lacking Munic...
Conclusions56
Conclusions57 Impact at exit does not consistently predictsustained impact two years later. There are specific ways to i...
Impact Assessment at Exit CanBe Misleading58 Impact assessment at exit does notconsistently predict impact two years late...
 Sustaining service provision and beneficiaryutilization of services and practices depends on threecritical factors:1. Re...
Provision of Free ResourcesPoses Risks to Sustainability60 Withdrawal of food rations or any other freeinput (as incentiv...
MCHN: Exit Strategy Models LackedSustained Sources of Resources, Capacity,and Motivation61 Motivation: Withdrawal of food...
MCHN: At least four types of resources mustbe considered in order to sustain CHW servicedelivery621. Resources that helped...
MCHN: Success of linking to governmentdepended on government capacity and resources63 Bolivia: Some CHWs continued linkag...
Water system exit strategy demonstrated thatmotivation, capacity, and resources are all criticalto sustainability64 Benef...
WatSan: Linkages to Government NotAlways Needed65 Linkages were actively avoided by most watercommittees; independence fr...
Sustainability of Water Quality Provides aCounterexample….66 Motivation for water quality testing is low becausebenefits ...
Agriculture Sector Exit StrategiesYielded a Mixed SustainabilityStory67 Model farmers (extension farmers) lackedmotivatio...
Improved agricultural practices generally declinedwhen requiring resources provided during theDAP68 Free inputswere provi...
Engagement in NRM activities andpractices declined dramatically afterprogram exit69 Food as pay (FFW) was withdrawn. Res...
COSAMO in Kenya Was a Model ofSustainability70 Sustained capacity, motivation, and resources.Sustained beneficiary utiliz...
Recommendations71
Program Design72 Sustainability should be built into the design ofprograms from the beginning. Plans must include: decis...
Project Cycles Should Be Longer andIncorporate Sustainability Benchmarks73
Phased ProgramImplementation74 Sustainable design and initial service delivery,demand creation, and partnership formation...
Program Monitoring andEvaluation75 Emphasis on assessment of impacts (e.g.,reduction in stunting) can undermine focus ons...
Program Withdrawal (Exit)76 Phase-over of responsibility must be gradual. Groups should be operating independently (with...
This study is made possible by the generous support of theAmerican people through the support of the Office of Health,Infe...
THANK YOU!
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But We Will Always be Here! Assuring Sustainable Benefits After Food Aid Programs_Beatrice Rogers_4.25.13

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But We Will Always be Here! Assuring Sustainable Benefits After Food Aid Programs_Beatrice Rogers_4.25.13

  1. 1. Beatrice Rogers and JenniferCoateswith:Johanna Andrews, Alexander Blau, Ameya Bondre,Jamie Fierstein, Kathryn Houk, Tina Galante, CarisaKlemeyer, Elizabeth Kegode, Leslie Sanchez“BUT WE WILL ALWAYS BE HERE!”ASSURING SUSTAINABLE BENEFITSAFTER FOOD AID PROGRAMS
  2. 2. Exit Strategy StudyOverview2
  3. 3. Study Rationale3 Title II programs closing in non-prioritycountries Little systematic knowledge of whetherprogram impacts are maintained and how tomaintain them Effectiveness of Title II programs depends onboth short-term impact and long-termsustainability
  4. 4. Study Objectives41. Determine the extent to whichactivities, outcomes, and impactsof Title II programs weresustained.2. Identify program characteristicsthat make it possible to sustainprogram activities and effectsafter the program shuts down.3. Assess how the process of“exiting” affects sustainability.4. Provide guidance to futureprograms on how to exit whileensuring sustainability.
  5. 5. Key Concepts5 Sustainability Sustainability ofimpacts amongprogramparticipants Diffusion of impactsto new populations Sustainability/expansion ofactivities Exit From specificactivities
  6. 6. Key Concepts: Exit Strategy/Sustainability Plan6 Explicit plan for transition from programsupport to exit Often called “sustainability plan” in agencydocuments Specifies approach to exit: phase over (towhom), phase out (of resources) Should include timeline and allocation ofresponsibility for ensuring progress
  7. 7. Study Methods Overview71. Qualitative picture of exit strategy implementationaround time of agency exit2. Qualitative inquiry one year after exit: to explore thesuccess of exit strategy in leading to sustainableservice provision (where applicable) and beneficiaryuptake3. Qualitative and quantitative data two years after exitto assess sustainability of impacts and outcomes4. Compare quantitative follow-on data to agencyendline survey data to determine sustainability andlink to exit strategies
  8. 8. Analytic Strategy: Associating ExitStrategy with Sustainability of Impacts8 Agency evaluations did not include controlgroups for attribution of impact Associations based on: Testing Implementation Pathways Sustainability of desired behaviors and impacts Continuation of service provision and utilization Implementation of an exit strategy Use of Secondary Data To serve as a point of comparison for survey results
  9. 9. Study Locations• Kenya• Bolivia• Honduras• IndiaSelection Criteria• Programs achieved keyimpacts on food security andmalnutrition• Programs implemented exitstrategies• Close-out coincided with studytime frame9
  10. 10. ConceptualizingSustainability and Exit10Sustained ImpactSustained Behaviors and/orService UtilizationSUSTAINEDSERVICEDELIVERYSUSTAINEDACCESSSUSTAINEDDEMANDSUSTAINEDRESOURCESSUSTAINEDCAPACITYSUSTAINEDMOTIVATIONSUSTAINEDLINKAGESProgram Exit StrategiesProgram Exit StrategiesEXTERNALFACTORS
  11. 11. 11 Critical combination of resources, motivation, andtechnical and managerial/administrative capacity Programs should be designed with exit in mind Gradual transition to independence with a period ofindependent operation before exit Importance of linkages - variable Impact at exit is not the same as sustained benefit lateron Provision of free resources poses challenges forsustainability Depending on government linkages is risky, anddepending on newly entering NGOs poses questions Different technical sectors face different challengesapplying these principlesEmerging Conclusions
  12. 12. RESULTS - BOLIVIA12
  13. 13. 13Title II Program Areas in Bolivia
  14. 14. 142002 20112008-9Agencies collectbaselinequantdataTuftscollectspost-programqualitativedata2010Tufts collectspost-programqualitative andquantitative datafollow-upquantitativesurvey replicatesagencies’endline surveys2004Agenciescollect mid-termquantand qualdataAgenciescollectendlinequal andquantdataStudy Methods Overview
  15. 15. 151. Maternal and Children Healthand Nutrition (MCHN)2. Water and Sanitation (WatSan)3. Agriculture/Rural IncomeGeneration (RIG) (after mid-term evaluation change in focusfrom production tocommercialization)4. Natural Resource Management(NRM)Program Technical Sectors
  16. 16. 16 Motivate CHWs to continue providing GMP, healthpromotion and home visits through social prestige andrespect; credentialing. Link CHWs to decentralized health services to assuresupervision, training, resources Teach mothers to substitute local foods for Title IIprovided foodsMCHN Exit StrategyMCHN Exit Strategy
  17. 17. 17 Prevalence of stunting declinedsubstantially during Title II andgenerally remained low after exit: ADRA, CARE, SC: No significantchange in stunting since exit FH: Stunting continued to declinesignificantly after exit While overall stunting in theDepartments declined during theperiod of Title II implementation, theAwardee declines were larger thanregional declines and Awardeesworked in areas with much higherMCHN Results: Stunting
  18. 18. 18Departmental statistics (< 5y)Title II Communities (3–35 mo)Percentage of children stunted (HAZ)Stunting
  19. 19. 19 GMP participation and prenatal care visits remained high Success of linkages to national government programs: Zero Malnutrition (ZM): nutritionalsupplements for children under 2; ComprehensiveNutrition Units (UNIs) at healthcare centers Bono Juana Azurduy (BJA) conditional cash transfersfor completing prenatal/postpartum care andgrowth monitoring visits Awardees with both a significant increase in GMP and thestrongest malnutrition impacts, CARE and FH, continue tooperate after exit GMP participation declined in SC communities, where fewergovernmental and NGO resources may be availableMCHN Results: Demand for ServicesGrowth Monitoring and Prenatal Care
  20. 20. 20Percentage of households taking child < 5y to GMPGrowth Monitoring Participation
  21. 21. 21Percentage of mothers reporting any prenatal care during last pregnancyPrenatal Care
  22. 22. 22Percentage of mothers reporting prenatal care in first 5 months during lastpregnancyPrenatal Care (< 5mo)
  23. 23. 23 Presence of a community healthworker remains high Coherent governmental and NGOinitiatives likely sustaining CHWpresence: Intercultural Family and CommunityHealth Program (SAFCI) Tarija’s “Health Guards” NGOs (Esperanza Bolivia, PlanInternational) adapt CHWs for theirown program activitiesMCHN Results: Service Delivery
  24. 24. 24 FH collaborates with UNICEF insome former Title II communities inmalnutrition prevention and GMP,with funding from Spain and USAID(Proyecto Integrado de SeguridadAlimentaria, PISA) In some cases local incentives maysustain CHWs Incorporation into water committee;profit-generating women’s groupsMCHN Results: Service Delivery
  25. 25. 25Percentage of communities reporting CHW presenceCommunity Health Workers (2011)
  26. 26. 26 EBF increased during the program and hasbeen sustained No cost; reinforced bygov’tprograms(BJA, ZM) All other practices have declined since exit Proper treatment of diarrhea, hygiene Importance of reinforcing behavior changemessages: Behaviors not reinforced through homevisits/trainings since exit Not prioritized since health system targetsservices like prenatal visits/GMPResults: MCHN Practices
  27. 27. 27Title II Communities National StatisticsPercentage of mothers reporting exclusive breastfeeding for child < 6moExclusive Breastfeeding
  28. 28. 28Diarrhea Treatment (food andliquid)Percentage ofmothers offeringsame/more food tochild duringdiarrheaPercentage ofmothers offeringsame/more liquidsto child duringdiarrhea
  29. 29. 29Percentage of mothers offering same/more food , liquid, orORT to childduring last diarrhea episodeDiarrhea Treatment (food, liquid, andORT)
  30. 30. 30Percentage of children 12–23 months of age receiving the third dose of DPT orpentavalente vaccineNote: No data available for ADRA in 2002 and 2004Vaccinations
  31. 31. 31 Sustainability of impacts and CHW service use due toalignment with government health programs andpresence of NGOs for continued support ANC and GMP remain high since exit Behavior change harder to sustain once food rationsremoved Rations had been provided children < 35 months andpregnant women participating in GMP/health talks Use of health services remains high since exit, but thelack of resources for community training and CHWsupervision appears to limit the quality of informationprovided or the incentive to continue household-levelbehaviors requiring time/resourcesMCHN Summary
  32. 32. 32Piped waterand latrinesAwardee provided inputs for construction of piped waterand latrinesElected water committees trained in system maintenanceand repair, and in financial management andadministration.Beneficiaries provided labor for construction, pay aconnection fee and a monthly fee for water use; water cutoff for lack of payment;User fees cover maintenance and repairsSome water committees were operating prior to Title II butreceived trainingWatSan Exit Strategy
  33. 33. 33 Vertical linkages to municipal government and horizontallinkages among water committees were part ofsustainability plan, not implementedWaterquality testing Water committees would take over water quality testingonce awardees leftHand washing and latrine use Hygiene behaviors promoted by community healthworkers in home visits would continueWatSan Exit Strategy
  34. 34. 34 Infrastructure continues to be available in Awardee areas Percentage of communities reporting piped water andlatrine availability generally maintained Immediate tangible benefit; responds to priority need;successful water committee model; infrastructure coverageis government priority Sanitation and handwashingpractices were not sustained after exit Water quality testing also notmaintainedResults: WatSan
  35. 35. 35Percentage of households with piped waterTitle II Communities Departmental StatisticsPiped Water
  36. 36. 36Percentage of communities maintaining their own water system (2011)Water System Maintenance
  37. 37. 37Percentage of households with latrineLatrine Access
  38. 38. 38Percentage of population using hygienic sanitation facilities (with signs of use,Awardee criteria)Latrine Use
  39. 39. 39Percentage of caregivers (responsible for food preparation) with properhandwashing practices (awardee criteria)Handwashing Practices
  40. 40. 40Percentage of caregivers using soap/detergentNote: No data available for CARESoap Use
  41. 41. 41Percentage of households using any water treatment (boiling, chlorination, SODIS)Note: No data available for FHWater Treatment
  42. 42. 42 Water and sanitation infrastructure demonstrated greatersustainability than hygiene behaviors and waterpurification Infrastructure: Tangible benefit, self-financing userfees, community capacity to operate system andmaintain accountable administration; not dependent onlinkages Behaviors: No immediate, tangible benefit, no financialincentives to motivate implementation, no nationalprogram focused on such behaviors, since nationalpriorities are more concerned with visible infrastructurecoverage Water quality: no independent operation before exitWatSan Summary
  43. 43. WatSan Sustainability!43
  44. 44. 44Rural Income Generation (RIG) ExitStrategy Model farmers were given free agricultural inputs andtraining in return for training other farmers Model farmers would continue to serve as technicalresources Focus on improved production and diversification shifted tocommercialization after MTE Farmers associations formed, trained in production and inmanagement, contracting Profits from increased sale would motivate sustained use ofpractices taught in the program, and profits would coverpurchase of inputs
  45. 45. 45Results Rural Income Generation(RIG) Agricultural income of farmers increased throughout theprogram, but fell substantially at follow-up, though remainingsubstantially higher than baseline Inputs provided free during program now must bepurchased Farmers who are members of producer associations (PA)have maintained substantially higher incomes than thosewho received training but are not PA members National GDP per capita continues to riseaccording to World Bank indicators
  46. 46. 46Mean Annual Income from Agricultural Sales by Farmers Trained in theProgram(adjusted for inflation, 2011=100)Agricultural Income
  47. 47. 47Mean Annual Agricultural Income: ProducerAssociation Members vs. Non-Members(2011)
  48. 48. 48Percentage of trained farmers belonging to a producer associationNote: No endline data available for ADRA and FHCARE participation data are only for farmers in promoted value chainsProducer Association Membership
  49. 49. 49Percentage of trained farmers adopting improved agricultural practices(Awardee criteria)Improved Agricultural Practices
  50. 50. 50 Percentage of farmers in producer associationsis declining Members of producer associations havesubstantially higher incomes than non-members Qualitative evidence indicates that farmers maydrop out of associations because they areunable to meet quality standards More successful farmers may be those able toafford inputs through the profits from marketing Commercialization model is successful forthose who can take advantage of itRIG Results Summary
  51. 51. 51 Use of inputs and promoted practices declining Inputs provided free during life of program nowmust be purchased; farmers may have becomeaccustomed to receiving these inputs without charge Practices sustained by trained farmers are thosereturning noticeable benefit and low cost (organicfertilizer, crop rotation) Proportion of farmers adopting improved practicessimilar among trained and un-trained farmers Individual producers likely copying improvedproduction methodsRIG Results Summary
  52. 52. 52 Sales through an association more likely whereassociations continue to receive support from externalsources (NGOs, foundations, government) Government partners have high rates of turnover,changing priorities, stretched budgets, and shortagesof technical staff; partnerships with buyers are morereliable Sustained operation of PAs is more likely whenresponsibility of negotiating contracts is transitionedgradually, with a period of independent operationRIG Results Summary
  53. 53. 53 Practices have declined significantly since exit Food for work and free inputs no longer available Motivation is low if tangible benefit is not perceived Continued practices are those that produce tangiblebenefit and do not require purchased inputs Municipal Natural Resource units are underfunded andunderstaffed Some activities produced lasting change during theprogram, but were not continued (forestation, terracing)-phase outResults: Natural ResourceManagement
  54. 54. 54Trained Farmers Adopting at LeastThree NRM Practices
  55. 55. 55 NRM activities largely not sustained after exit Technical capacity was strong; resources andmotivation lacking Municipal support was weak or lacking Withdrawal of food and free inputsjeopardized sustainability of activitiesNRM Results Summary
  56. 56. Conclusions56
  57. 57. Conclusions57 Impact at exit does not consistently predictsustained impact two years later. There are specific ways to increase thelikelihood of sustainability. Provision of free resources poses risks tosustainability.
  58. 58. Impact Assessment at Exit CanBe Misleading58 Impact assessment at exit does notconsistently predict impact two years later. Many activities, practices, and impactsacross sectors declined over the two yearsafter exit. These declines are related to inadequatedesign and implementation of sustainabilitystrategies and exit processes.
  59. 59.  Sustaining service provision and beneficiaryutilization of services and practices depends on threecritical factors:1. Resources2. Technical and Management Capacity3. Motivation There are often synergies among these threeelements. Best practice models have emerged for each – andthey are often sector-specific. The relevance of linkages is sector-specific.Specific Ways to Increase theLikelihood of Sustainability59
  60. 60. Provision of Free ResourcesPoses Risks to Sustainability60 Withdrawal of food rations or any other freeinput (as incentive) jeopardizes sustainabilitywithout consideration of substitute incentives. Provision of free food rations risks creatingunsustainable expectations. Consideration of alternative incentive structuremust be incorporated into program design. Beneficiaries receiving free inputs to supportprogram activities may not be willing or able toreplace them once project ends.
  61. 61. MCHN: Exit Strategy Models LackedSustained Sources of Resources, Capacity,and Motivation61 Motivation: Withdrawal of food was adisincentive for participation in and provision ofgrowth monitoring. In Kenya, withdrawal of food resulted inreduced participation in growth monitoring.NGO return also reinstated the incentive. In Honduras, withdrawal of food reduceddemand participation in growth monitoring,while in Bolivia, the government implementeda cash incentive for growth monitoring andpromotion. Overall community health worker (CHW) serviceprovision declined in Kenya, Bolivia, andHonduras with decline in material incentives and
  62. 62. MCHN: At least four types of resources mustbe considered in order to sustain CHW servicedelivery621. Resources that helped CHWs do their job, such asweighing scales, report forms, and bicycles, as well astraining and supervision from the health sector2. Resources that they offered the community as anincentive to participate in activities3. Benefits accrued to the CHWs that incentivized theirservice, such as access to goats distributed to women’sgoat groups4. CHW time and its converse, the opportunity cost of timespent on CHW activities rather than on other productivelabor• No fee for service models were observed in the health sector.
  63. 63. MCHN: Success of linking to governmentdepended on government capacity and resources63 Bolivia: Some CHWs continued linkages to healthsystem; public health system provided services. In Honduras, linkages with health system workeduntil government resources ran out. In Kenya, government did not/could not take theresponsibility for supervision, training, or provisionof resources resulting in declines in CHW servicequality, motivation, and capacity when they werenot being reinforced.
  64. 64. Water system exit strategy demonstrated thatmotivation, capacity, and resources are all criticalto sustainability64 Beneficiaries are motivated to pay for waterservices that are reliable, convenient, andabundant. Technical and management capacity ofwater committees permits system tocontinue operation post-project. Fees paid by consumers provide ensuredresources for system maintenance.
  65. 65. WatSan: Linkages to Government NotAlways Needed65 Linkages were actively avoided by most watercommittees; independence from governmententities that could be unreliable sources ofsupport
  66. 66. Sustainability of Water Quality Provides aCounterexample….66 Motivation for water quality testing is low becausebenefits are not visible. Therefore willingness to pay was low. Capacity-building activities during the DAPs didnot emphasize water quality. Water quality testing was not operatingindependently at exit. No linkages to support water quality testing werein place at exit.
  67. 67. Agriculture Sector Exit StrategiesYielded a Mixed SustainabilityStory67 Model farmers (extension farmers) lackedmotivation, resources, and reinforcement ofcapacity to continue providing technical assistanceafter incentives were withdrawn. Service provisionlargely declined. Producer associations participation rates werevariably low/declined. PAs provided concretebenefits in some countries but not all. Commercialization activities produced sustainable
  68. 68. Improved agricultural practices generally declinedwhen requiring resources provided during theDAP68 Free inputswere providedduring programlifeand Use of theseinputs declinedwhen theyneeded to bepurchased afterthe program
  69. 69. Engagement in NRM activities andpractices declined dramatically afterprogram exit69 Food as pay (FFW) was withdrawn. Resources in the form of inputs (seedlings, etc.)was no longer provided free of charge. Motivation was lacking unless costs were low anddirect benefits to farmers were high. Linkages to local government environmental groupswere ineffective as those groups lack resources. Positive changes (reforestation, terracing, etc.)were maintained, though activities to expand thesechanges were not.
  70. 70. COSAMO in Kenya Was a Model ofSustainability70 Sustained capacity, motivation, and resources.Sustained beneficiary utilization and impact. Self-financing: No outside seed money and no otherexternal resources needed. Modular training program built solid technical andmanagerial capacity. There was a gradual withdrawal of NGO after a periodof COSAMO group independent operation Linkages were not necessary – could pay for technicalassistance of trained resource persons.
  71. 71. Recommendations71
  72. 72. Program Design72 Sustainability should be built into the design ofprograms from the beginning. Plans must include: decision about approach(phase out, phase over); explicit benchmarks forprogress; timeline; clear allocation ofresponsibility, graduation criteria Each element — capacity, motivation, andresources — must be considered, withredundancies and contingencies for externalshocks built into the plan.
  73. 73. Project Cycles Should Be Longer andIncorporate Sustainability Benchmarks73
  74. 74. Phased ProgramImplementation74 Sustainable design and initial service delivery,demand creation, and partnership formation Strengthening capacity, developing ensuredresources, ensuring appropriate linkages,promoting independent operation Independent operation of program activitiesand gradual agency withdrawal
  75. 75. Program Monitoring andEvaluation75 Emphasis on assessment of impacts (e.g.,reduction in stunting) can undermine focus onsustainability. Progress toward sustained capacity, motivation,and resources should be measured as processindicators during monitoring. Evaluations should be done at each phase;criteria for assessment will differ by the
  76. 76. Program Withdrawal (Exit)76 Phase-over of responsibility must be gradual. Groups should be operating independently (with agencybackstopping) before full withdrawal. Community organizations and individuals should be aware oftheir post-exit roles and responsibilities from the outset. Philo so phy of sustainability should be embedded throughoutimplementation to withdrawal. Be aware that communities may not commit to independence,in the expectation of new sources of external support.
  77. 77. This study is made possible by the generous support of theAmerican people through the support of the Office of Health,Infectious Diseases, and Nutrition, Bureau for Global Health,and the Office of Food for Peace, Bureau for Democracy,Conflict and Humanitarian Assistance, U.S. Agency forInternational Development (USAID), under terms ofCooperative Agreements GHN-A-00-08-00001-00, AID-OAA-A-11-00014, and AID-OAA-A-12-00005 through the Food andNutrition Technical Assistance III Project (FANTA), managedby FHI 360.The contents are the responsibility of Tufts University and donot necessarily reflect the views of USAID or the United StatesGovernment.77Acknowledgments and Disclaimer
  78. 78. THANK YOU!

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