Sustainability in the health sector: The research study

Why has investment in health in some developing countries failed to result in a sustained capacity to deliver basic health care? This paper presents an overview of the sustainability problem. It is based on Save the Children Fund's (SCF) global research on sustainability in the health sector carried out from 1991 to 1993 in five countries: Uganda, Nepal, Pakistan, Ghana and Vietnam. Sustainability is defined as the capacity of the health system to function effectively over time with minimum external input. Following a discussion of the concept of sustainability and its emergence as a popular policy issue, the paper offers a framework for analyzing health system sustainability and considers the concept's relevance to major investors in health in low-income countries.