When implementing hygiene behaviour change programmes, it is important to understand that it is a process rather than a one-time event. Short-term projects are unlikely to lead to sustainability, so instead it is worth creating and investing in long-term strategies. Here are some recommendations to help sustain programme management of current COVID-19 programmes:
Integrate current work with other sectors: Increased inter-sectoral collaboration can lead to an increased impact on a shared target population. COVID-19 is affecting people in numerous ways beyond their physical health, whether it be their mental health, education, nutrition or livelihood. Designing, or adapting your program to address multiple challenges and integrating your response with other sectors can provide a more comprehensive system to support the population and make health and hygiene components more feasible and acceptable. A systematic review that looked at which factors facilitated programme sustainability identified having partnerships with various stakeholders as being important in ensuring the sustainability of a health programme.
Design programmes to complement and in turn, shape government strategies: Government-led initiatives are more likely to be sustained if they have the support of outside organisations. When organisations work alongside the government in implementing programmes, it is also more likely that the government will see the value in continuing the programme and their commitment to it. An example of a successful government-NGO collaboration is tuberculosis control in Bangladesh where greater coverage and access to necessary services was achieved. In southern Africa, programmes for orphans and vulnerable children were sustained in part due to the collaboration between the government and NGOs.
Involve new actors: Building partnerships between the public and private sector, as well as other actors such as the media or universities, can help maintain support and progress of your programme. They also may be able to provide more resources, drive innovation and take on responsibilities. Involving new partners can require steep learning curves, and it is helpful to share a common goal but keep each actor’s roles and responsibilities clear.
Partner with civil society organisations: Civil society organisations are a part of the communities they serve and this allowed them to respond rapidly to the pandemic in ways that were innovative and context appropriate. Consequently the COVID-19 pandemic has encouraged many international NGOs and government agencies to strengthen their partnerships with local actors who are better placed to understand community needs and may be able to work more safely in communities than external actors. It is important that support to civil society organisations continues to be strengthened and that these organisations play a role in setting their own future agendas and contributing to resilience building.
Improve coordination mechanisms and develop shared strategies: Coordinating efforts and developing shared strategies between implementers helps avoid redundancies and makes it easier to achieve programmatic goals. Some responses to COVID-19, including the UN’s Global Humanitarian Response Plan, encourages coordination between international organisations, NGOs, and national governments. Coordination is most sustainable when it is government led and aligned to border national strategies. Over the course of the pandemic new coordination mechanisms have developed such as Risk Communication and Community Engagement (RCCE) working groups. It is important at this stage to review the mid and long term purpose of these coordination groups and identify ways that collaboration, learning and sharing can continue. This does not always necessitate that these new COVID-19 coordination measures need to be maintained. For purposes of sustainability, it may be much better for coordination structures to be embedded in existing and well functioning government mechanisms. For more guidance on effective government led COVID-19 response and coordination initiatives follow the tips in this article.
Continue monitoring and evaluation: Monitoring and evaluating your programme will make it easier to identify areas that need improvement and so that you can adapt to changing needs. Programme evaluation can also help provide information on progress and potentially programmatic impact. For further guidance on monitoring the progress of your programme see the Hygiene Hub resources on monitoring and evaluation.
Be transparent about programming: Transparency of information is especially important during public health crises in order to build and maintain trust, manage fear and effectively support the adoption of health and hygiene guidance by the population. Organisational transparency in terms of their ways of working and the costs associated with programming can help maintain accountability, reduce corruption, and increase efficiencies. The sustainability of short term programmes can be supported by developing clear programme manuals and sharing programme materials so that initiatives can be easily replicated or adapted by others. Honest sharing of programmatic monitoring and evaluation information can help other actors to build on programmatic strengths and learn from past mistakes, strengthening the quality of future programming.
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