Exit Strategies: How to Ensure Sustainability of Impact after

Program Exit

Beatrice Lorge RogersResearch Team: Jennifer Coates

Katie Houk, Elizabeth Kegode, Leslie Sanchez

TOPS FNS Knowledge Management WorkshopAddis Ababa, June 11, 2012

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

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)

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

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

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

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

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

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

Sustainability Throughout the Project Cycle

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

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

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

Hypothesized Factors Contributing to Sustainability

STRATEGIESPhase over at most local level possible

Post-project source of resources identified and testedBuild capacity at most local level

Explicit ES benchmarks and timelinesAdvance communication to stakeholders about exit

Independent operation before exit (exit transition is gradual)

STRATEGIESPhase over at most local level possible

Post-project source of resources identified and testedBuild capacity at most local level

Explicit ES benchmarks and timelinesAdvance communication to stakeholders about exit

Independent operation before exit (exit transition is gradual)

Health Sector Exit Strategies

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.

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.

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

Health Sector Exit Strategies• Health behaviors were maintained –

depending on resource cost• Participation in growth monitoring sessions

fell off

Ag Sector Exit Strategies

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

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

Water/Sanitation Exit Strategies

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

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

Livestock Sector Sustainability Strategies

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

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

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

Microfinance Sector Sustainability Strategies

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

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 groupsStrategies:• Graduated independent operation; agency support only

as “technical resource” after first savings cycle. • groups inspiring new activity – groups training new groups.

Natural Resource Management Exit Strategies

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

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

Infrastructure Exit Strategies

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

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

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

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).

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

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)

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

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

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

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

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

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

THANK YOU!

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