Factors Influencing Health Education Programme Sustainability in Non-Governmental Organisation-Led Initiatives in South South Nigeria

Programme sustainability is a critical challenge for non-governmental organisations implementing health education initiatives in Nigeria, where donor funding cycles and implementation capacity often determine longevity of impact. This study investigated factors influencing the sustainability of health education programmes led by non-governmental organisations in South South Nigeria, focusing on programmes in Rivers, Edo, and Delta states. A multiple case study design was used, with in-depth interviews conducted with 36 programme managers, health educators, and community stakeholders from 12 programmes that had operated for at least two years. Document review and focused group discussions supplemented interview data. Thematic analysis guided by the Programme Sustainability Framework was applied. Results identified community ownership (mentioned by 89 percent of respondents), integration into government health systems (78 percent), diversified funding (72 percent), and adaptive management (67 percent) as the most critical sustainability factors. Programmes that transitioned health education activities to community volunteer networks demonstrated the highest post-funding sustainability. The study recommends that non-governmental organisations adopt sustainability planning from programme inception and design explicit transition strategies to government and community ownership. Keywords: programme sustainability, health education, NGO-led initiatives, South South Nigeria, community ownership