A methodological approach and framework for sustainability assessment in NGO- implemented primary health care programs

Eric G. Sarriot, Peter J. Winch, Leo J. Ryan, Janice Bowie, Michelle Kouletio, Eric Swedberg, Karen LeBan, Jay Edison, Rikki Welch, Michel C. Pacqué

Research output: Contribution to journalArticlepeer-review

59 Scopus citations


An estimated 10.8 million children under 5 continue to die each year in developing countries from causes easily treatable or preventable. Non governmental organizations (NGOs) are frontline implementers of low-cost and effective child health interventions, but their progress toward sustainable child health gains is a challenge to evaluate. This paper presents the Child Survival Sustainability Assessment (CSSA) methodology - a framework and process - to map progress towards sustainable child health from the community level and upward. The CSSA was developed with NGOs through a participatory process of research and dialogue. Commitment to sustainability requires a systematic and systemic consideration of human, social and organizational processes beyond a purely biomedical perspective. The CSSA is organized around three interrelated dimensions of evaluation: (1) health and health services; (2) capacity and viability of local organizations; (3) capacity of the community in its social ecological context. The CSSA uses a participatory, action-planning process, engaging a 'local system' of stakeholders in the contextual detinition of objectives and indicators. Improved conditions measured in the three dimensions correspond to progress toward a sustainable health situation for the population. This framework opens new opportunities for evaluation and research design and places sustainability at the center of primary health care programming.

Original languageEnglish (US)
Pages (from-to)23-41
Number of pages19
JournalInternational Journal of Health Planning and Management
Issue number1
StatePublished - Jan 1 2004


  • Child health
  • Community health
  • Evaluation
  • Non-governmental organizations
  • Sustainability
  • Sustainable development

ASJC Scopus subject areas

  • Health Policy


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