| Sustainability Defined | Sustainability and the Prevention Planning Process | Taft Middle School Prevention Plan | Why Sustainability Is Important |

Sustainability is one of many terms used to refer to program continuation beyond the initial funding period. Other terms include: maintenance, incorporation, integration, durability, routinization, and institutionalization. The following definitions of sustainability and institutionalization may provide a context for thinking about this topic

Definitions of Sustainability

• The capacity to maintain service coverage at a level that will provide continuing control of a health problem (Claquin, 1989).

• The capacity of a project to continue to deliver its intended benefits over a long period of time (World Bank's definition in Bamberger and Cheema, 1990).

• The ability of a program to deliver an appropriate level of benefits for an extended period of time after major financial, managerial, and technical assistance from an external donor is terminated (U.S. Agency for International Development, 1988).

Definitions of Institutionalization

• The active process of establishing your initiative -- not merely continuing your program, but [also] developing relationships, practices, and procedures that become a lasting part of the community (Kramer, no date).

• The long-term viability and integration of a new program within an organization (Steckler and Goodman, 1989).

• The process by which new practices become standard business in a local agency (Yin, 1979).

Note that the sustainability definitions emphasize the importance of lasting health benefits, while the definitions of institutionalization focus more narrowly on program continuity. For this online event, the term "sustainability" coincides most closely with drug prevention and school safety coordinators' goals: It does not restrict program continuation to survival within an organizational structure, nor does it imply that a program must remain static and fixed, as the terms "routinization" or "institutionalization" might.

References

Bamberger, M. & Cheema, S. (1990). Case studies of project sustainability: Implications for policy and operations from Asian experience. Washington, DC: The World Bank.

Claquin, P. (1989). Sustainability of EPI: Utopia or sine qua non condition of child survival. Arlington, VA: REACH.

Kramer, R. (no date). Strategies for the long-term institutionalization of an initiative: An overview. Available online at http://ctb.lsi.ukans.edu/tools/EN/sub_section_main_1329.htm.

Shediac-Rizkallah, M. C. & Bone, L. R. (1998). Planning for sustainability of community-based health programs: Conceptual frameworks and future directions for research, practice and policy. Health Education Research: Theory and Practice, 13(1), 87-108.

Steckler, A. & Goodman, R. M. (1889). How to institutionalize health promotion programs. American Journal of Health Promotion, 3, 34-44.

U.S. Agency for International Development (1988). Sustainability of development programs: A compendium of donor experience. Washington, DC: USAID.

Yin, R. K. (1979). Changing urban bureaucracies: How new practices become routinized. Lexington, MA: D.C. Health and Company.