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Table 1 Sustainability framework: determinants of sustainability

From: Sustainability of health information systems: a three-country qualitative study in southern Africa

Factor Conditions hypothesized to result in greater sustainability
Program/project-specific factors
 Type/goal(s) Programs/projects that are better able to demonstrate results, often by being more narrowly focused
 Perceived effectiveness Higher degree
 Financing Ability to secure multiple sources of non-donor financing, particularly from national sources (during or by end of program/project)
 Training Greater emphasis
Organizational factors
 Local-level modifiability Greater local-level ability to modify implementation to local needs and conditions
 Donor-client interactions Characterized by joint participation/consensus-building
 Donor-community interactions Characterized by joint participation/consensus-building
 Project champion Existing and effective
 Integration Higher degree of integration within host institution, national health authority institution or activities, and/or recipient community needs/priorities
 Institutional strength/capacities Stronger
Contextual factors
 Concurrent projects/donor-supported activities Fewer similar other programs/projects and/or minimization of competing health problems
 Community characteristics Higher receptivity to participation
 Political, economic and cultural characteristics Socio-political stability, economic stability/growth, higher governmental institutional capacity