Recorded presentation

Nat Robison, BA, Consejo de Salud Rural Andino, c/o Curamericas, 224 E. Martin St., Raleigh, NC 27601, 919-821-8000, nrobison@csra-bolivia.org

Among the essential ingredients for the long-term sustainability of community health programs are a secure flow of resources; an ongoing demand for services; technical expertise; an organizational structure that guarantees accountability, sustains clear goals and objectives, reinforces core values, and provides a stable labor environment; long-term leadership; and ownership. Except for the flow of resources and technical expertise, the other ingredients are commonly neglected in discussions and planning for sustainability.

During the past 20 years, CSRA, a Bolivian NGO, has worked with the Ministry of Health (MOH), municipal governments and communities to manage health programs. Each of the geographical units managed by CSRA included personnel paid by the MOH.

Working with different levels of government and communities during this time has shown that political favoritism, a lack of long-term professional commitment, poor motivation, racism, and professional jealousy significantly influence the quality and coverage of health services. These problems are strongly associated with a lack of sense of ownership of goals and objectives and the absence of leadership capable of motivating staff and generating needed change.

Ownership and leadership are as important as, or perhaps more important than, financial security and technical expertise in enhancing the long-term survival of health benefits for under-served communities. CSRA has developed a management model that provides leadership and fosters a greater sense of ownership on behalf of management, staff and local representative authorities and communities. Local NGOs are one viable model for offering all of the essential ingredients for sustainability, including leadership and ownership.

Learning Objectives: At the conclusion of this presentation, the participants will be able to

• Understand that ownership and leadership are two often underestimated ingredients of a comprehensive view of community health program sustainability. 2. Discuss CSRA’s approach to promoting stronger leadership and ownership of community-based health care programs.

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Recorded presentation