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Sustainability of a Community-Based CHOICE Program to Improve the Health and Nutrition Status of Mothers and Infants in Indonesia


Objectives Few studies have been undertaken to determine whether and how project results are sustained. University of Notre Dame (ND) and Project Concern International conducted a Post-Project Sustainability Study (PSS) of a USAID-funded program (CHOICE), implemented in Indonesia, Banten province, between 2003 and 2007, in order to determine lasting effects and improve PSS methodologies. Methods Sustainability was measured through a comparison of data collected on mother–infant pairs in 2014 with final evaluation data from 2007; and through a comparison of 2014 data collected from the CHOICE villages and comparison villages. Results The analysis showed positive differences in multiple indicators in CHOICE villages between 2007 and 2014, including births attended by skilled personnel (Mean Difference 48.56, 95% CI 38.68 to 58.43) and treatment of diarrhea (MD 16.42, 95% CI − 0.94 to 33.37). However, only one statistically significant difference between intervention and comparison groups in 2014 was observed, infants with diarrhea whose mothers sought advice or treatment (MD − 5.48, 95% CI − 9.55 to 1.39), showing more mothers in intervention group sought advice or treatment. Because contextual factors were not studied in detail and baseline data was not available for the comparison villages, it is difficult to determine the reasons for the results. Given that longitudinal data was not collected, it is also difficult to determine whether results fluctuated between 2007 and 2014. Conclusions for practice This PSS contributes to the limited body of knowledge in sustainability research. Lessons learned from this study will increase potential for sustainable impact of projects, as more rigorous measurement will lead to greater overall understanding of how sustainability actually “happens”.

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The Child Health Opportunities Integrated with Community Empowerment (CHOICE) program was made possible by the generous support of the American people through the United States Agency for International Development (USAID) Child Survival and Health Grants Program (CSHGP), Cooperative Agreement Number: CHS-A-00-03-00017-00, October 2003–September 2007. The CHOICE Post-Project Sustainability Study (PSS) was made possible by Project Concern International’s (PCI) commitment to sustainability and investment of private resources in developing standards, tools, guidelines, and PSS methodologies. This study is one example of PCI’s leadership and its pledge to expand the body of knowledge on sustainability in order to help implementing organizations, project teams, local partners, donors, and other stakeholders to better understand how project results are sustained and adapted and evolve after a project comes to an end.

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Correspondence to Lila Kumar Khatiwada.

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Eder, C., Khatiwada, L.K. & Schooley, J. Sustainability of a Community-Based CHOICE Program to Improve the Health and Nutrition Status of Mothers and Infants in Indonesia. Matern Child Health J 22, 903–912 (2018).

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  • Maternal and child health
  • Malnutrition
  • Public health intervention
  • Sustainability
  • Indonesia