ABSTRACT
Sustainable programmes in the context of global health initiatives, especially as related to medical physics, involve several key concepts: (1) continuity for a defined period of time, (2) successful implementation of strategies for improvement, (3) successful education programmes resulting in change of practice for enhancements in patient treatments, and (4) well-defined metrics to determine the success of the programme. There are multiple factors involved in developing successful and sustainable programmes, which can be loosely categorized as contextual and programmatic factors. Contextual factors involve the three pillars of sustainability, including economic, social, and environmental considerations. The programmatic factors relate to the direct activities of the programme ranging from leadership to financing, to training, and to appropriate technology. Eight key domains have been defined that influence a programme's capacity for sustainability: environmental support, funding stability, equal partnerships, organizational capacity, programme evaluation, programme adaptation, communication, and strategic planning. Various indices are available that relate to a country's economic status as well as allowing for an assessment of potential barriers to development projects. The sustainability considerations described in this chapter provide an overall framework that is useful for project decision-makers as well as those who are directly involved in organizing and/or implementing such projects.
