Sustaining Health Management Development Initiatives: Lessons from Zambia

Discusses the lessons learned from a two‐year, WHO/DANIDA funded health management development project at district level in Zambia. The project was implemented by the Zambian Ministry of Health whose active interest and political commitment ensured the continuation and the country‐wide expansion of the management development process. After describing in detail project objectives, implementation and evaluation findings, suggests some factors which are likely to have contributed to the sustainability of the management development process after the end of external assistance. The most important of these factors was the right “fit” between donors' and recipients' policies. Donors showed a long‐term perspective and a conscious attention to avoid actions which might induce dependence. This matched very well with the recipient's strategic vision, political will, and the project's pattern of “ownership”.