Making Your Program Sustainable

Every family planning program should be concerned with making itself sustainable. A sustainable family planing program is able to continue its activities and meet its objectives year after year, to make plans for the future and fulfill those plans despite changes in the outside environment, and to develop diversified financial support so that its existence is not threatened by the loss of a single funding source.

Although organizations will achieve sustainability through different means and by different routes, sustainable organizations have some common characteristics. They provide quality services to those who cannot pay the full cost of the services as well as those who can. This means that these organizations have developed mechanisms to subsidize the cost of services for the poor and underserved. Sustainable organizations are also able to adapt to changing environments and client needs. For example, a program that has traditionally served women in an urban clinic setting might tailor services to meet the needs of other client groups, such as adolescents. Finally, sustainable organizations seek to develop independent, diversified, and dependable sources of revenue while they become less and less dependent on external funds. Having a diversified and dependable source of funds gives these organizations greater control over their programs and greater flexibility and freedom to chart their own course.

The environment in which family planning programs operate is changing at an unprecedented pace. Managers must develop suitable strategies to cope with the demographic changes as well as changes in the source and level of funding and in consumer demands. In order to manage effectively within this complex environment, managers will need to provide stable leadership, be flexible in their approach to service delivery, respond to the changing needs of the client population, and find innovative ways to increase revenues and reduce costs.

Sustainability has become a priority of government agencies, private organizations, and donors, all of whom are seeking to establish a solid foundation for the future. There are three components of organizational sustainability:

• A stable organization
• A clear demand for family planning services
• The ability to exert greater control over resources

The first component of sustainability, organizational stability, differs from the private to the public sector. In the private sector, organizational stability means survival - the ability of the organization to provide services over time despite changes in the external environment. Because public sector family planning organizations are created by governments, their survival is not in question. Stability in a public sector organization is achieved when the organization has ensured that clients will always have access to family planning services regardless of who is providing them. Despite these different definitions, the road to organizational stability is similar for both public and private sector organizations. In both sectors, organizations must be well managed in order to achieve stability and will benefit from having committed and stable leadership.

Creating demand for services is the second component of organizational sustainability. Public sector organizations work to increase universal demand for services without particular attention to which service provider will meet this demand. Private sector organizations concentrate their efforts on identifying demand within specific markets and on determining how best to serve them. In both public and private programs, ensuring client satisfaction is critical to increasing demand for services.

The third component for achieving sustainability is to have greater control over resources. In the private sector, organizations must be able to determine what the real cost of services are, to set realistic prices for specific services, to diversify revenues, and to make decisions on the basis of financial as well as service information. These organizations must strive to decrease their dependence on donors and increase their levels of self-financing. Public sector organizations, on the other hand, must develop ways of increasing revenues through innovative cost-sharing mechanisms In addition, these organizations will need to develop greater local control over resources through progressive decentralization.

To determine whether your organization faces any barriers to sustainability, ask yourself the following questions:

Does your organization have a strategic plan that articulates a clear mission and charts a strategy for responding to future changes in client needs and in the environment?

Can your organization recruit and retain highly motivated and committed staff?

Do you provide high-quality services to a broad spectrum of the population, including the poor and underserved?

Does your organization receive funding from more than one donor?

Are you able to get information on how much services cost or on revenues?

Does your organization have a system for generating revenues from the services provided?

Does your organization have a mechanism for spending locally-generated revenues at the local level?

Vignette - Meeting the Challenge of a Decrease in Funding

Examples from Around the World - Approaches to Creating Sustainability in Family Planning Programs