Table 1 Description of the interventions included in the review

Abamecha et al., 2021 [44]; Ethiopia

Social and behavior change communication interventions for malaria prevention. Focused on promoting malaria-preventive practices at the school and community-level

School-based

Not reported

2017–2019 [Assessment period: At the end of the program, 10–30, 2020]

Mixed-methods:Quantitative data (survey) and qualitative data (interviews) collected from officials from education and health offices, community health extension workers (HEWs), school directors, school malaria focal teachers and the program’s field officers

Not reported

Ashaba et al., 2022 [47];

Hobbs et al., 2022;

Uganda

Healthy Child Uganda- MamaToto Program

A maternal and child health intervention that included health system strengthening, health facility capacity strengthening, and deployment of Community Health workers (CHWs)

Multi-level intervention

[district, community, and health facility]

Not reported

Study Period: 2012–2014 [Assessment Period: July–August 2018]

Mixed-methods:

Sustainability-focused qualitative evaluation. Focus group discussions and in-depth interviews among CHWs, health providers (health assistants, clinicians), community development officers, and community leaders

Retrospective operational review of an existing population-based database comprising all CHWs in two districts

Yes, at the time of publication

Noted as retention of over 80% of volunteer CHWS

Blackstone et al., 2017 [52]; Ghana

Task-shifting strategy for hypertension (TASSH) control in Ghana

Health-facility based

Not reported

2014–2016

[Assessment period: 2017]

Mixed-methods:

Concept mapping with nurses to understand community health nurses' perceptions of barriers and enablers to sustaining a task-shifting program

Unclear status in Ghana, but has been adapted for implementation in Nigeria

Busza et al., 2018 [63]; Busza et al. 2018b [64];

Zimbabwe

Zimbabwe Study for Enhancing Testing and Improving Treatment of HIV in Children.

A community-based intervention offering community health worker home visits to caregivers of children living with HIV in seven high-density communities in Harare, Zimbabwe

Community-based

[delivered at homes]

Not reported

[Assessment period: end of trial]

Qualitative method:

Longitudinal semi-structured qualitative interviews with the 19 CHWs who delivered the ZENITH intervention at three time periods during the trial: baseline (following recruitment and training but before home visits work started), midline (after one year of implementation of the intervention), and at the end of the intervention 2 years later

No

Chelagat et al., 2021 [65]; Chelagat et al., 2019 [62]; Kenya

The Leading High-performing

Healthcare Organisations’

(LeHHO).

The leadership program aims to enable senior national and county management teams to address the most critical health system challenges in a devolved system of government

Multi-level

Health-facility-based and community-based

Comprehensive conceptual sustainability from Iwelunmor et al. 2015 [31]

2011–2016

[Assessment period: post-training]

Qualitative method:

Interviews nested within a quasi-experimental study

Partly

85% of the site sustained the intervention

Chiliza et al., 2021 [53]; South Africa

PEPFAR program to enhance linkage to care for HIV

Health-facility based

Not reported^a

However, the background references literature on sustainability

2007–2012

[ Assessment period: October 28, 2018

to April 3, 2019]

Mixed-methods:

Health facilities records and interviews conducted with health facility managers, clinical nurse practitioners, government officials, and NGO program managers

Partly

Chowdhary et al., 2022 [45]; Ethiopia

CARE TESFA program (TESFA means “hope” in Amharic). Delivered reproductive health and financial savings curricula to married girls [10–19 years] via reflective dialogues in peer-based solidarity groups

Community-based

Not reported^a

However, the background references literature on sustainability

2010–2013

[Assessment Period: 2017- 4 years after TESFA implementation ended]

Qualitative method:

Focus group discussions and in-depth interviews with study participants

Yes

Noted as 88% of surveyed groups were found to still be active and using the sexual and reproductive health and economic empowerment curricula

Crocker et al., 2017 [54]; Ethiopia and Ghana

Community-led total sanitation program. Focused on addressing open defecation that triggers emotions to generate a collective demand for sanitation within a community

Community-based

Not reported

Ethiopia: 2012–2013

Ghana:2013–2014

[Assessment: One after completion of the intervention]

Quantitative method

Ethiopia– > quasi-experimental design. Survey data was collected at baseline, immediately after the interventions (midline), and again one year later (end of trial)

Ghana – > Survey data collected immediately after the interventions (midline) and again one year later (end of trial))

Not reported

Dharmayat et al., 2019 [51]; Malawi

The Supporting Low-cost Intervention For Disease

Control (Supporting LIFE).

The SL eCCM App was developed as an Android a smartphone application that replicates the Community Case Management program decision aid tool routinely used by Health Surveillance

Assistants (HSAs) in Malawi. This app enables HSAs to enter the same information (usually gathered using a paper-based CCM form), including personal details (e.g., gender), clinical symptoms (e.g., fever) and clinical measurements (e.g., breathing rate). Data is entered directly into the application. The app then provides the user with the recommended treatment for the child, such as treatment at home with medication or referral to a higher-level clinical facility

Health-facility-based

Shediac-Rizkallah and Bone framework conceptualizing program sustainability [12]

4-year program

[Assessment period: At the end of the implementation -January and March 2017]

Qualitative method: Interviews among stakeholders in Malawi, including district health officers, zonal health officer, Integrated Disease Surveillance, and Response (IDRR) programmer, Central Monitoring and Evaluation Division (CMED) officer, ministry of health, senior member involved in research and NGO members

Unclear

Fontanet et al., 2020 [55];

Scott et al., 2021; Fong et al. 2022; Zambia

Maternity Homes Access in Zambia project.

Community-driven maternity waiting homes model in rural Zambia. This involved the construction of 10 maternal waiting homes(MHW) adjacent to rural health centers able to provide obstetric care for uncomplicated deliveries and within 2 hour to a referral hospital equipped to care for women experiencing obstetric complications. The 20 MWHs met the three main pillars of the Infrastructure, equipment, and supplies to ensure a safe, comfortable, and functional structure; Policies, management, and finances to ensure local oversight and sustainability of the homes; Linkages and services to ensure integration with the formal health system

Community-based

Scheirer and Dearing’s framework for the sustainability of public health programs [66]

[Assessment period: 2016–2018; 3-time points: immediately following intervention lunch, during the intervention and after implementation phase-out]

Qualitative method:

Focus group discussions and in-depth interviews with community members, and community health volunteers

Not reported

Graham et al., 2022 [50]; Graham et al. 2019 [67]; Nigeria

Nigeria Oxygen Implementation project to improve hospital oxygen systems in 12 hospitals in southwest Nigeria. 12 hospitals were provided pulse oximeters and training and oxygen delivery systems The multifaceted intervention (full oxygen system) was delivered at the cluster (hospital) level and involved (1) a standardized oxygen equipment package, (2) clinical education and support, (3) technical training and support, and (4) infrastructure and systems support

Health facility-based

Not reported

2015–2021 [Assessment Period: medium-term assessment-2018–2020]

Mixed-methods: Cross-sectional facility assessments, clinical audits, WHO facility assessment tools, direct observation, recording of informal feedback from technicians, cost information, and clinical outcome data

No

Hirschhorn et al., 2021 [46]; Rwanda

Under-5 mortality reduction evidence-based intervention implemented before and during the period of focus (2000–2015), with pneumococcal vaccine (PCV) as the case study. Various evidence-based interventions focused on amenable under-5 mortality in Rwanda

Health facility-based

Hybrid Implementation Research (IR) Framework that includes aspects of EPIS, RE-AIM, and CFIR

2000–2015

[Assessment period: End of trial]

Qualitative method:

Key informant interviews from implementing non-governmental organizations, multilateral organizations, and donor organizations who had been involved in partner-supported or partner-led activities

Yes

Full vaccination rates with PCV remained consistently high from introduction through the end of the study period and beyond, with coverage at 97–98% since 2010

Katuramu et al., 2020 [48, 68]; Uganda

The START-ART rapid ART initiation program included training healthcare workers and introducing additional resources to support the program

Health facility-based

Capability, opportunity, or motivational components model (COM-Model) [69]

April 2013 to June 2015 -Intervention period

1 August 2015 to 31 July 2016- Sustainability period. [Assessment period: 4 October 2017 to 15 February 2018]

Mixed-methods: This included a cross-sectional patient record review and key informant interview. Key informant interviews were conducted at one facility that sustained the intervention and one that did not

Partly

Engagement of some of the participants in ART adherence

Moore et al., 2023 [43];

Stark et al., 2020; Burkina-Faso

Un Oeuf intervention. The intervention aimed to increase egg consumption in children ages 6–24 months through a culturally tailored Behavioral change communication strategy to improve poultry production and empower women. Messaging encouraged women to feed enrolled children an egg every day

Community-based

Not reported

[Assessment period: data collected at the end line and immediately following the endline, all in 2019]

Mixed-methods: Combining quantitative and qualitative Data. This included cross-sectional survey and focus group discussions exploring the barriers and facilitating factors and the sustainability and scalability of the intervention

Yes

Continued use of program activities

Moucheraud et al., 2017 [56]; Malawi, Zambia, and Zimbabwe

Electronic health information systems (EHIS) project

Health facility-based

Sustainability framework that maps the determinants of sustainability based on recommendations from Bossert 1990, Stirman et al. 2012 [17], Gruen et al. 2008 [11], and Scheirer 2005 [71] (n = 1)

The project started in 2001 in Malawi, 2009 in Zambia, and 2009 in Zimbabwe

[Assessment period: 2013]

Qualitative method:

Interviews with major stakeholders involved in ongoing donor-funded projects for strengthening HIV care through EHIS

Unclear

Mwale et al., 2021 [57]

Mwale et al., 2021b [70]; Malawi

CARE’s Community Score Card© Malawi, as part of the Maternal Health Alliance Project (MHAP)

a social accountability approach that aids in assessing, monitoring, and evaluating government services with a focus on healthcare

Community-based

Not reported

However, the background references literature on sustainability

2012–2015 [Assessment period: ~ 2.5 years after the end of the formal MHAP project]

Mixed-methods:

Cross-sectional design comparing the sustainability of various partner-led approaches, focus groups with members of Community Health Advisory Groups (CHAGs) and youth groups, and semi-structured interviews with local and district government officials, project staff, and national stakeholders to understand how and in what form intervention activities are continuing

Yes

Community adoption/ownership of the program

Obi-Jeff et al., 2022 [58]; Nigeria

Immunization Reminder and Information SMS System (IRISS) in Kebbi State. IRISS used SMS to inform and educate the public about the importance of immunization and remind caregivers/parents of their child’s immunization schedules, including the vaccination schedules of health facilities in their locality

Community-based

RE-AIM [71]

May 20,2019-May 31, 2020 [Assessment period: June 2020]

Qualitative method:

Focus Group Discussions, In-depth Interviews (IDIs), and Key Informant Interviews with community members, government program managers, government health workers, and policymakers

No

Onwujekwe et al., 2019 [59]; Nigeria

A Free Maternal and Child Health program

The National Health Insurance Scheme (NHIS)-MDGs Free Maternal and Child Health Program was an intervention to address the high mortality among women and children. The intervention program provided access to pregnant and children under-5 to free health care services from primary health centers and then referred to selected general hospitals when there were complications

Health facility-based

Health system building blocks [72]

2009–2015

The program started in 2009 with six pilot states and was scaled-up to 12 states in phases 2, 3, and 4

[Assessment period: Feb-Aug 2016]

Qualitative method:

In-depth interviews with NHIS, OSSAP‑MDG,

HMOs, Public health facilities, state/local governmentand communities; document review, including policy documents, program implementation reports and other relevant reports

No

Prasad et al., 2022 [42]; Tanzania

The Program to Reduce Maternal Deaths in Tanzania. This task-sharing intervention focused on increasing access to maternal and child health services by utilizing assistant medical officers, facility improvement intervention to increase access to high-quality services, and demand generation activities

This involved leveraging task sharing, which allowed certain cadres of associate clinicians—such as assistant medical officers (AMOs)—to provide comprehensive emergency obstetric and newborn care (CEmONC)

Health facility-based

 Not reported

2006–2019

[Assessment period: During implementation and end of Implementation]

Mixed-method approach:

This included the documentation of operational performance and outcomes in program-supported facilities, reproduction health surveys, health facilities assessment, clients and providers surveys, pregnancy outcome monitoring

Yes

The program fully transitioned to the Government of Tanzania's oversight

Speizer et al., 2019 [73]; Speizer et al.,2019b [74]; Olumide et al., 2020 [60]; Nigeria

The Nigerian Urban Reproductive Health Initiative (NURHI). The NURHI program utilized demand generation activities [community-level outreach events, distribution of information, education, and communication

(IEC) materials at public and private health facilities in the communities and through

mass media, including television and radio programs] to encourage interpersonal discussion about family planning, reduce

barriers, myths, social stigma, and increased approval of family planning methods

Multi-level

Community-based and health facility-based

Shediac-Rizkallah and Bone [12]

Phase I implementation (2009–2014)

Phase II implementation (2015-) [Assessment period:

Evaluation in 2014, end of Phase I

Evaluation in 2015 & 2017 of the phase II sites]

Mixed-methods:

Descriptive characteristics from longitudinal data collected from the study sites, Principal component analysis to explore predictors of sustainability and in-depth interviews with service providers

No

Wickremasinghe et al.,2021 [61]; Nigeria

Village Health Worker Scheme. This involved village health workers working in their communities to promote maternal and child health. Their role involved delivering maternal, newborn, and child healthcare messages, encouraging improved health and healthcare-seeking behaviors, and undertaking basic healthcare provision, such as treating pregnant women for anemia and referring them to health facilities, promoting healthcare uptake

Community-based

Based on the literature on sustainability

[Specifically, a conceptual framework informed by Hirschhorn et al. 2013, Larson et al. 2014, Torpey et al. 2010, and WHO and ExpandNet (2010)

2016−2019

[Assement period:

2017 and 2018. Multiple assessments: at setting-up phase (Sept 2017]; consolidation phase (Jan-Feb 2018); and mature phase (Nov-Dec-2018)]

Mixed-methods:

Descriptive characteristics for the longitudinal data from 2015 and 2017 from two cities in the study. Principal component analysis to explore predictors of sustainability and in-depth interviews with service provider

No

Zakumumpa et al., 2016 [75, 76]; Zakumumpa et al., 2017; Zakumumpa et al., 2018 [49]; Uganda

Uganda national ART scale-up program at public and private health facilities. Focused on promoting uptake of ART

Health-facility based

Shediac-Rizkallah and Bone Sustainability Framework [12]

2004–2009 [Assessment period:2014–2015]

Mixed-methods:

Surveys among ART clinic managers, in-depth interviews with patients and clinic managers, health facilities evaluations, on-site checklists, and document review

Unclear