Exit Strategies: How to Ensure Sustainability of Impact after Program Exit

1. Exit Strategies: How to Ensure Sustainability of Impact after Program Exit Beatrice Lorge Rogers Research Team: Jennifer Coates Katie Houk, Elizabeth Kegode, Leslie Sanchez TOPS FNS Knowledge Management Workshop Addis Ababa, June 11, 2012

2. Acknowledgements • FANTA2 and USAID Food for Peace • Research team • Tufts team • Research collaborators in country • Cooperating sponsor agencies • Community counterparts • Community members The authors have no conflict of interest to report

3. Overview of Session • Exit Strategies Results to Date (30 mins) • Breakout: (20 mins) • How feasible is it to incorporate these principles into your own programs? Which ones? • Report out and discussion (20 mins) • The way forward: future contributions of TOPS activities (15 mins)

4. Overview of the Exit Strategy Study • Rationale • Title II programs closing in non-priority countries • Little systematic knowledge of how to maintain program impacts • Effectiveness of Title II programs depends on both short term impact and long term sustainability • Immediate and long term impact may be trade-offs

5. Overview of the Exit Strategy Study • Goal: Provide guidance to Food for Peace and to Cooperating Sponsors • General approaches to planning for program exit • Key elements of an exit strategy, including development and implementation • How to build sustainability into program design from the beginning

6. Objective of Exit Strategy Study • Identify program characteristics that make it possible to sustain program effects after the program shuts down • Determine whether implementing explicit exit strategies contributes to sustainability • Provide guidance to future programs on how to exit while assuring sustainability

7. Key Concepts • Sustainability • Sustainability of activities • Sustainability of impacts • Expansion of activities and improvement of impact • Long term sustainability may compete with short term impact • Exit • From specific activities • Departure of CS from the area

8. Key Concepts • Phase out: program activities stop; benefits/effects are presumed to be lasting without further input • Phase over: responsibility for program activities is transferred to another entity • Community based organization • Government (local to national) • Key individuals • Another NGO or donor

9. Key Concepts • Exit strategy • Explicit plan for transition from program support to exit • Specifies approach to exit: phase over (to whom), phase out (of resources) • Includes timeline, benchmarks for progress, mechanisms for monitoring and allocation of responsibility for ensuring progress • Should be part of long term program implementation • Often called ‘sustainability plan’ in agency documents

10. Sustainability Throughout the Project Cycle

11. Methods: Overview of Study • Three phases • Baseline at time of exit – qualitative • Quantitative end line evaluations from agencies • Qualitative description one year after exit – to identify the trajectory of program development, determine critical periods for success • Qualitative and quantitative data two years after exit • Mix of qualitative and quantitative data • Data collection now complete except in India

12. Methods: Overview of the StudyStudy Locations • Bolivia • Kenya • Honduras • India • Selection is based on • Programs judged to have had impact • Programs implemented explicit exit strategies or incorporated sustainability plans

13. Program Technical Sectors Maternal and child health and nutrition Agricultural production/income generation Potable water and sanitation Livestock sector development Paravets Market development Micro-finance and micro-lending Natural resource management Infrastructure

14. Hypothesized Factors Contributing to Sustainability STRATEGIES Phase over at most local level possible Post-project source of resources identified and tested Build capacity at most local level Explicit ES benchmarks and timelines Advance communication to stakeholders about exit Independent operation before exit (exit transition is gradual)

15. Health Sector Exit Strategies

16. Health Sector Exit Strategies • Capacity • CHWs would continue using knowledge and skills after the project ended. • Resources: • Resources for service delivery (eg. Scales, growth charts) to be provided by the MOH after phase-over. • Rations for supplementary feeding to be replaced with local foods.

17. Health Sector Exit Strategies • Motivation: • CHWs would rely intangible incentives, like community respect • Mothers would be motivated by visible improvements in child health • Linkages: • Horizontal: CHWs would meet regularly as a group • Vertical: Government will provide oversight and supervision after end of project.

18. Health Sector Exit Strategies • Self financing model is not feasible in health sector • Government support for health activities depends on resources, commitment and capacity • Motivation for CHWs diminished unless linkages with formal health sector and demand for services were maintained

19. Health Sector Exit Strategies • Health behaviors were maintained – depending on resource cost • Participation in growth monitoring sessions fell off

20. Ag Sector Exit Strategies

21. Ag Sector Exit Strategies • Capacity • Knowledge taught by Extension farmers would be self-sustaining. • Farmers Associations would have technical and mgmt skills to continue • Resources: • Ag inputs would be purchased from profits from crop sales • Linkages • Value chain linkages would continue to strengthen • Government ag extension workers would provide some technical support • Motivation: • Benefits – income improvements - demonstrated during project would motivate continuation

22. Ag Sector Exit Strategies • Commercialization of production was the key to sustainability in agricultural interventions • Gradual withdrawal allowed farmer marketing groups to develop independent functioning • Capacity building to manage commercial activities was key

23. Water/Sanitation Exit Strategies

24. Water/Sanitation Exit Strategies • Capacity: • Technicians trained in maintenance and repair • Water committees trained to manage funds • Resources: • User fees cover expenses • Incentives: • Beneficiary appreciation of piped water in home • No such appreciation of microbiological quality • Linkages: • Vertical linkages for water quality testing, horizontal linkages for cross-community committee support • Technical quality of the infrastructure is critical • Access to adequate water source is necessary

25. Water/Sanitation Exit Strategies • System of user fees to support maintenance of water systems was the critical element in sustainability of water systems • Depends on willingness to pay (beneficiaries) and capacity to enforce (water committees) • Willingness to pay depends on quality and reliability of water supply

26. Livestock Sector Sustainability Strategies

27. Community-based Animal Health Workers • Capacity: • Train Community Based Animal Health Worker (CBAHW) or Paravets/“Peritos” who will assume primary responsibility after project. • Resources: • Fee-for-service structure and access to microfinance • Motivation • Willingness to pay for perceived benefit to livestock • Vertical Linkages: • Government veterinary officers engaged in training and field visits. • Government to provide extension support

28. Livestock Sector Market Support • Capacity: Livestock marketing management committees (LMMCs) and radio operators trained • Resources: Market user-fees • Incentives: In-kind benefits for LMMC members, such as privileged access to market and price data. • Vertical Linkages: • LMMCs linked to various government institutions • Joint trainings and sectoral evaluations. • Phase-out: Responsibility left to LMMCs

29. Livestock Sector • Paravet system works because of fee for service model and paravet access to training through government ministry • Livestock market committees work because they are institutionalized and demand for services is sustained – market user fees are paid • Drought, cattle raids threaten ability to pay

30. Microfinance Sector Sustainability Strategies

31. Microfinance Sector Sustainability Strategies • Capacity: Individuals savings and loan groups trained • Resources: No outside capital required. Women save and take loans. Donations made to support group operations. • Motivation: Credit, visible impact, field agents receive payment for services. • Linkages: COSAMO savings groups linked to a community field agent who is tied to MFI

32. COSAMO: Microfinance Success Story • Capacity: Individuals savings and loan groups trained to manage their groups • Resources: No outside capital required. Women save and take loans. Donations made to support group operations. • Incentives: Credit, huge visible impact, female empowerment; field agents receive payment for services. • Linkages: Women’s groups are training new groups Strategies: • Graduated independent operation; agency support only as “technical resource” after first savings cycle. • groups inspiring new activity – groups training new groups.

33. Natural Resource Management Exit Strategies

34. Natural Resource Management Strategies • Capacity: • Communities trained in construction and maintenance of NRM infrastructure • Resources: • Establish functioning businesses (e.g. greenhouses) • Incorporate into local government plans (budgets and oversight) • Motivation: Contributes to productive agricultural activity

35. Natural Resource Management Strategies • Sustainability was achieved when interventions met short term visible needs and provided tangible material benefit • When this is the case, FFW no longer needed • Phase out is possible if permanent changes are made

36. Infrastructure Exit Strategies

37. Infrastructure Exit Strategies • Capacity: Train community members in construction and maintenance • Resources: Municipalities, CBOs recognize benefits and fund maintenance • Motivation: Clear benefits may motivate volunteer labor • Linkages: • Quality of construction is critical

38. What’s Working: Resources • Self-financing business models (water [irrigation, household] paravets) • Profits/increased income (agriculture, microenterprises, microcredit) • Funds from government or other external source (inherent risk) • Vertical linkages, if resources are there to support those linkages • Health sector • Ag marketing contracts

39. What’s Working: Capacity • Behavior change is sustained where new resources are not required or when they are available. • High quality assets and technical capacity developed during the project were maintained

40. What’s Working: Withdrawal • Gradual phase over of responsibility • Creating community awareness of its roles and responsibilities after exit from the outset • Philosophy of sustainability from program design to withdrawal. • Longer duration of operation in a community prior to exit (when agencies also manage expectations of permanence).

41. What’s Not Working: Withdrawal • Withdrawal of food rations (as incentive/pay): jeopardize sustainability of program activities when there is no consideration of substitute incentives • Food rations: created unsustainable expectations • Vertical linkages with government, where governments are understaffed and under-resourced, or when their priorities shift. • Horizontal linkages: mixed results

42. Preliminary Conclusions • Motivation to continue activities and practices must be combined with the necessary resources and technical capacity • Tangible benefit is critical, but capacity and resources equally so • Source of material resources • Business model (potable water, irrigation) • Profits/increased income (agriculture, microenterprises) • Funds from government or other external source (inherent risk)

43. Preliminary Conclusions • Quality of assets produced and technical capacity are critical • Interventions and exit/sustainability plans must be adapted to the local context • Resource availability • Local institutions

44. Preliminary Conclusions • Exit is more successful if community is aware of its roles and responsibilities after exit • Exit is more successful if phase over of responsibility is gradual – transition to independent functioning

45. Preliminary Conclusions • Building on institutional priorities of the government can be successful if commitment is long term and resources are available • Willingness to pay for “public” services can jeopardize resource flows • Government priorities shift; governments at all levels may be understaffed and under-resourced

46. Preliminary Conclusions • Different program components can reinforce each other • Water/sanitation with health • Agriculture/RIG with natural resources • Agriculture/RIG with nutrition (diet) • Withdrawal of food rations (as incentive/pay) can jeopardize sustainability of program activities if there is no consideration of substitute incentives • And food rations may have created unsustainable expectations

47. Summary • Motivation: Tangible benefit is key to sustainability • Resources: Source of resources is critical • Capacity building must be both technical and managerial • Time operating in community less important than hypothesized • Importance of vertical linkages depends on sector and capacity

48. Summary • Horizontal linkages depend on context and sector • Sustainability should be built into the design of programs from the beginning • Multiple elements of sustainability must be implemented together – all are necessary

49. THANK YOU!

50. Your opinions?