Service Delivery & Sustainability Plan

B.R. Shamanna2nd COSI Symposium

VEIRC, New Delhi

Service Delivery

•Community Level•Primary Level•Secondary Level

Service Delivery

•Primary PreventionHealth PromotionSpecific Protection

•Secondary PreventionEarly Diagnosis – ScreeningTreatmentReferral

•Tertiary PreventionLimitation of Disability & Rehabilitation

Service Delivery - Roles

•Eye Care organizations

•Development organizations

•Education organizations

•Rehabilitation organizations

•Other Organizations – groups, clubs etc.

Sustainability

“Sustainability is seen as the ability of the system to produce benefits valued sufficiently by users & stakeholders leading to ensuring enough resources to continue activities with long term benefits”

Sustainability“A Health Service is considered sustainable when operated by an organizational system with the long term ability to mobilize and allocate sufficient resources for activities that meet individual or public health needs”

Sustainability – Development Parlance!

“The capacity of the health system to function effectively over time with a minimum of

external support”

Sustainability

“Program continuity or sustainability refers to the capacity of a program to continue functioning, supported by its own resources (human, material and financial), even when external sources of funding have ended”

Components for Sustainable Development

Technical Sustainability Social/Cultural Sustainability Political Sustainability Financial Sustainability Managerial Sustainability

• Technical - staff, training, skills

• Managerial - organization, delivery,

systems, marketing

• Financial - cost reduction, containment,

sharing, income generation

• Leadership - vision, mission, values

Sustainability

Sustainability

•Community•Primary Level•Secondary Level

Questions?

How do you plan to obtain long –term programmatic support?

How do you plan to get community’s support?

What will the in-country support be? (Salaries, commodities, office space, equipment, volunteers, IEC, Community Funding, User fees, Income Generation etc)

Questions? At what time will the above be introduced

to the project? How does the organization plan to get

political support for the project? (Government support, relationship with government policy, networking organizations having common goal etc)

Describe plans for continued financial support. (Donor support, fund raising, how funding is solicited?)

Strategies for Financial Sustainability

Fees for service National and International donors Income generating activities In-kind support – Volunteer, space Collaborative interventions Cross subsidies – sharing of costs

Strategies for Financial Sustainability

Self sustaining activities internally Community networks Insurance – Group, Social etc Corporate support Fundraising campaigns

Strategies for Institutional/ Program Sustainability

Institutional Vision, Mission and Values Staff competency – technical and Mgmt. Institutional evaluation systems Regular performance reviews “Change” – adapt and flexibility

Strategies for Political Sustainability

Government support – organization Government support – project Community support – both above! Complementary policies Networking and collaborations Lobbying & Pressure groups – Advocacy Media management & meetings

Measures to Increase Sustainability

• User charges & community management • Management reforms• Designing a public health package &

strengthening donor assistance• Compulsory health insurance for work

force• Increasing effectiveness & minimizing

costs

Sustainability

Not an end state but a process Viable Organization Managerial & Technical Expertise Necessary Resources

Foundations of Sustainable Eye Health Program

• Effective Leadership• Managerial Competence• Clinical Competence• Partnerships and Collaborations• Financial Viability• Process to sustain the above