Overview
With health needs outstripping the amount of outside funding available, all health programmes need to work towards becoming sustainable. Only those who succeed in this are likely to survive into the future.
All projects need to ensure that they remain financially viable through a variety of measures. Important methods are cost cutting and increased efficiency in programme management. Most projects will also need to recover costs either by charging user-fees, through insurance schemes or from a variety of other means for generating income, of which several examples are described.
Projects should also develop alliances with one or more partner agencies, with the private sector and with government. Both the methods of cost recovery and any alliance formed need to be monitored to ensure that the poor are never denied health care, and that ethical values are maintained.
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Excerpt from setting up community Health programmes by Ted Lankester
"As all of us involved in Community Based Health Care soon come to know, sustainability is one of the ‘buzz words’ we continually hear about and talk about. Usually we think of sustainability in financial terms. We consider ways in which our project can be less dependent on outside supporters.
It is helpful to try and define more clearly what sustainability actually means. Here is one definition.
Sustainable projects are those whose internal and external methods of raising finance are likely to ensure their long-term survival.
This does not mean these projects are entirely self-sufficient, i.e. depending on their own resources alone. Rather it means they are self-reliant, i.e. are able to assume responsibility for their own futures. This will usually be through a varied mix of cost recovery from users, income generation and selective support from outside.
Understanding the difference between self-sufficiency and self-reliance is important. Few if any projects will manage to be entirely self-sufficient (free from any dependence on outside funding) especially in the poorest areas where Community Based Health Care is of the greatest value. But all projects must work towards self-reliance, always making sure that the poorest community members and subgroups have priority."
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