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Health interventions introduced as part of donor-funded projects need careful planning if they are to survive when donor funding ends. In northeast Nigeria, the Gombe State Primary Health Care Development Agency and implementing partners recognized this when introducing a Village Health Worker Scheme in 2016.

This paper, published in Health Policy and Planning, presents a qualitative study focussing on the Village Health Worker (VHW) Scheme’s sustainability.

The paper authored by IDEAS researchers aims to contribute to the body of literature on sustaining donor-funded interventions as well as presenting lessons aimed at decision-makers seeking to introduce similar schemes in other Nigerian states and in other low- and middle-income settings.

In 2017 and 2018, the team conducted 37 semi-structured interviews and 23 focus group discussions with intervention stakeholders and community members. Based on respondents’ accounts, six key actions emerged as essential in promoting the VHW Scheme’s sustainability:

  • government ownership and transition of responsibilities,
  • adapting the scheme for sustainability,
  • motivating VHWs,
  • institutionalizing the scheme within the health system,
  • managing financial uncertainties
  • and fostering community ownership and acceptance.

This study suggests that for a community health worker intervention to be sustainable, reflection and adaption, government and community ownership and a phased transition of responsibilities are crucial.

 

Tribute to Deepthi Wickremasinghe

This article is based on the work of its lead author, Deepthi Wickremasinghe, who passed away in April 2020. An important part of Deepthi’s work was to give stakeholders in Nigeria real-time feedback on emerging findings as the project developed. And so, Deepthi contributed very directly to the scheme’s success. Deepthi made important scientific contributions to our understanding of sustainability for improved health and was a conscientious, kind, gentle and committed colleague who is greatly missed.

 

Authors

Profile picture of Deepthi Wickremasinghe
Deepthi Wickremasinghe

Research Fellow

Profile picture of Dr Neil Spicer
Dr Neil Spicer

Associate Professor

Profile picture of Dr Nasir Umar
Dr Nasir Umar

IDEAS Nigeria Country Coordinator and Research Fellow

Profile picture of Dr Barbara Willey
Dr Barbara Willey

Assistant Professor in Epidemiology

Profile picture of Dr Tanya Marchant
Dr Tanya Marchant

IDEAS Principal Investigator and Associate Professor

Yashua Hamza

Childcare and Wellness Clinics

Dr Abdulrahman Shuaibu

Executive Secretary Gombe State Primary Health Care Development Agency

Dr Ahmed Gana

Commissioner for Health Gombe State

Magdalene Okolo

Society for Family Health (former)

Jennifer Anyanti

Society for Family Health