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

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

Independent operation of services and systems Partnership formation, demand creation Capacity development; development of financing sources

Transfer and Phaseout

Sustainable Design

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 Study Study 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

RESOURCES Self financing business model Legal registration Alternative sources of resources are operational Food ration withdrawal CAPACITY Access to continued training Technical and managerial System for identifying and training replacements MOTIVATION Visible benefit Profits/Income Felt need in community High community participation Prestige and social respect LINKAGES Vertical and horizontal linkages Long-term contracts Designated responsible party for supervision

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)

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 phaseover. 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 selfsustaining. 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

 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

Microfinance Sector Sustainability Strategies

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: Womens 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.

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

Whats 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

Whats 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

Whats 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).

Whats 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!

Your opinions?