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The Avahan Transition: Effects of Transition Readiness on Program Institutionalization and Sustained Outcomes

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  • Sachiko Ozawa
  • Suneeta Singh
  • Kriti Singh
  • Vibha Chhabra
  • Sara Bennett

Abstract

Background: With declines in development assistance for health and growing interest in country ownership, donors are increasingly faced with the task of transitioning health programs to local actors towards a path to sustainability. Yet there is little available guidance on how to measure and evaluate the success of a transition and its subsequent effects. This study assesses the transition of the Avahan HIV/AIDS prevention program in India to investigate how preparations for transition affected continuation of program activities post-transition. Methods: Two rounds of two surveys were conducted and supplemented by data from government and Avahan Computerized Management Information Systems (CMIS). Exploratory factor analysis was used to develop two measures: 1) transition readiness pre-transition, and 2) institutionalization (i.e. integration of initial program systems into organizational procedures and behaviors) post-transition. A fixed effects model was built to examine changes in key program delivery outcomes over time. An ordinary least square regression was used to assess the relationship between transition readiness and sustainability of service outcomes both directly, and indirectly through institutionalization. Results: Transition readiness data revealed 3 factors (capacity, alignment and communication), on a 15-item scale with adequate internal consistency (alpha 0.73). Institutionalization was modeled as a unidimensional construct, and a 12-item scale demonstrated moderate internal consistency (alpha 0.60). Coverage of key populations and condom distribution were sustained compared to pre-transition levels (p

Suggested Citation

  • Sachiko Ozawa & Suneeta Singh & Kriti Singh & Vibha Chhabra & Sara Bennett, 2016. "The Avahan Transition: Effects of Transition Readiness on Program Institutionalization and Sustained Outcomes," PLOS ONE, Public Library of Science, vol. 11(7), pages 1-15, July.
    • Handle: RePEc:plo:pone00:0158659
    DOI: 10.1371/journal.pone.0158659
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    References listed on IDEAS

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    1. Pluye, Pierre & Potvin, Louise & Denis, Jean-Louis, 2004. "Making public health programs last: conceptualizing sustainability," Evaluation and Program Planning, Elsevier, vol. 27(2), pages 121-133, May.
    2. T. S. Breusch & A. R. Pagan, 1980. "The Lagrange Multiplier Test and its Applications to Model Specification in Econometrics," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 47(1), pages 239-253.
    3. Pluye, Pierre & Potvin, Louise & Denis, Jean-Louis, 2004. "Corrigendum to `Making public health programs last: conceptualizing sustainability' [Evaluation and Program Planning 27 (2004) 121-133]," Evaluation and Program Planning, Elsevier, vol. 27(4), pages 453-453, November.
    4. Sara Bennett & Suneeta Singh & Daniela Rodriguez & Sachiko Ozawa & Kriti Singh & Vibha Chhabra & Neeraj Dhingra, 2015. "Transitioning a Large Scale HIV/AIDS Prevention Program to Local Stakeholders: Findings from the Avahan Transition Evaluation," PLOS ONE, Public Library of Science, vol. 10(9), pages 1-16, September.
    5. Bennett, Sara & Ozawa, Sachiko & Rodriguez, Daniela & Paul, Amy & Singh, Kriti & Singh, Suneeta, 2015. "Monitoring and evaluating transition and sustainability of donor-funded programs: Reflections on the Avahan experience," Evaluation and Program Planning, Elsevier, vol. 52(C), pages 148-158.
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    2. Ilene S Speizer & David K Guilkey & Veronica Escamilla & Peter M Lance & Lisa M Calhoun & Osifo T Ojogun & David Fasiku, 2019. "On the sustainability of a family planning program in Nigeria when funding ends," PLOS ONE, Public Library of Science, vol. 14(9), pages 1-18, September.
    3. Budi Aji & Dian Anandari & Henny Soetikno & Herman Sumawan, 2022. "Sustaining maternal and child health programs when donor funding ends: A case study of stakeholder involvement in Indonesia," International Journal of Health Planning and Management, Wiley Blackwell, vol. 37(4), pages 2049-2062, July.

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