Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #112479

Andrew C. Beggs, MM¹, Christopher Schwabe, Dr², Joseph K. Carter, MPH¹, and Jaime Kuklinski³. (1) International Division, Medical Care Development , Inc, 8401 Colesville Road, Suite 425, Silver Spring, MD 20910, 301-562-1920, mcdi@mcd.org, (2) International Division, Medical Care Development Inc, 104 Bradford Road, Keene, NH 03431, (3) One World Development Group, Casa Mallo, Malabo, Equatorial Guinea

Introduction: With funding from Marathon Oil, Medical Care Development International and its partners OWDG, MRC, Harvard and Yale Universities are implementing a Malaria Control Project on Bioko, Equatorial Guinea consisting of (1) indoor residual spraying, (2) case management, and (3) surveillance, monitoring and evaluation. Two years into this unique 6-year commercial/non-governmental/government joint venture, the stakeholders have begun planning for the integration of Project activities into the Ministry of Health's (MOH's) ongoing program.

Purpose: To present a methodology for achieving the sustainable transfer of responsibility for externally-funded project activities to government.

Methods: A detailed integration strategy was developed at the request of Marathon Oil which specifies activities to be sustained by government and the timeline for transfer of responsibility. The structure and staffing of the MOH was examined and departments identified to which responsibility would be transferred. Risk factors associated with integrating and sustaining Project activities were specified, as well as the necessary conditions for overcoming them. A risk-influence-impact analysis identified risk factors over which the Project could have impact versus those requiring system-wide structural reform. A 5-year Integration Action Plan was developed to address the risk factors amenable to Project intervention, and was incorporated into the overall Project action plan / budget.

Results: The integration strategy provided a road map for transferring responsibility for project activities to the MOH. Stakeholders are working together to progressively share responsibility and develop the capacity for a full transfer in a phased and sustainable manner. The Project's action plan was adapted to include the integration-related activities. Benchmarks and objectively verifiable indicators for integration were specified and are being monitored. Finally, Marathon Oil has encouraged the incorporation of the integration strategy within the Project budget and Government agreed to assume progressive financing responsibility for the Project's malaria control activities.

Implications: Lip service is often paid to sustainability, but the necessary conditions for achieving it are rarely addressed in a systematic manner within projects. The early specification of an integration strategy, its full incorporation within the on-going project and budget, and a commitment to progressive transfer of responsibility are hallmarks of a unique commercial/non-governmental/government joint venture that expects to achieve sustainability where others have failed.

Learning Objectives:

• Participants will learn and discuss a methodology for effective planning for transition from an externally funded project to a viable government program.

Keywords: Sustainability, Planning

Related Web page: mcdi.mcd.org/

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.