ArticleBMJ open2022
Qualitative evaluation of enabling factors and barriers to the success and sustainability of national public health institutes in Cambodia, Colombia, Liberia, Mozambique, Nigeria, Rwanda and Zambia.
Article in BMJ open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
What it found
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Who cites it
4 citing papers in PubMed.
- National Public Health Institutes in Africa, 2010-2025: pathways, governance, and outcomes, a scoping review.BMC health services research · 2026Article
- Strengthening National Public Health Institutes for resilient health systems: evidence to inform policy and decision makers in the Eastern Mediterranean region.Frontiers in public health · 2025Article
- Lessons learned during the establishment of a functional National Public Health Institute in the Democratic Republic of Congo: from 2018 to 2024.The Pan African medical journal · 2024Article
- The Evaluation of Psychometric Properties of the Women's Health-enabling Factors Questionnaire among Menopausal Women.Journal of mid-life healthArticle
Corrections and comments
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Authors and funding
17 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesThe success of National Public Health Institutes (NPHIs) in low-income and middle-income countries (LMICs) is critical to countries' ability to deliver public health services to their populations and effectively respond to public health emergencies. However, empirical data are limited on factors that promote or are barriers to the sustainability of NPHIs. This evaluation explored stakeholders' perceptions about enabling factors and barriers to the success and sustainability of NPHIs in seven countries where the U.S. Centers for Disease Control and Prevention (CDC) has supported NPHI development and strengthening.
designQualitative study.
settingCambodia, Colombia, Liberia, Mozambique, Nigeria, Rwanda and Zambia.
participantsNPHI staff, non-NPHI government staff, and non-governmental and international organisation staff.
methodsWe conducted semistructured, in-person interviews at a location chosen by the participants in the seven countries. We analysed data using a directed content analysis approach.
resultsWe interviewed 43 NPHI staff, 29 non-NPHI government staff and 24 staff from non-governmental and international organisations. Participants identified five enabling factors critical to the success and sustainability of NPHIs: (1) strong leadership, (2) financial autonomy, (3) political commitment and country ownership, (4) strengthening capacity of NPHI staff and (5) forming strategic partnerships. Three themes emerged related to major barriers or threats to the sustainability of NPHIs: (1) reliance on partner funding to maintain key activities, (2) changes in NPHI leadership and (3) staff attrition and turnover.
conclusionsOur findings contribute to the scant literature on sustainability of NPHIs in LMICs by identifying essential components of sustainability and types of support needed from various stakeholders. Integrating these components into each step of NPHI development and ensuring sufficient support will be critical to strengthening public health systems and safeguarding their continuity. Our findings offer potential approaches for country leadership to direct efforts to strengthen and sustain NPHIs.
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