Evaluation of sustainability of non-communicable diseases risk factor program in Malaysia

Abstract

Abstract Background Non-communicable diseases (NCDs) in Malaysia have risen substantially over the last two decades. We aimed to (i) evaluate the sustainability of the existing NCDs risk factor program implemented under the National Strategic Plan and (ii) identify challenges and factors impeding the sustainability of the NCDs program. Methods A mixed-method approach using a combination of the Program Sustainability Assessment Tool with 40-item instrument assessing 8 domains (organizational capacity, program adaptation, program evaluation, communications, strategic planning, funding stability, environmental support and partnerships) and 5 open-ended questions were administered to 80 key managers from district directors of chronic disease programs in Malaysia. The mean score for each of the 8 sustainability domains and the overall mean sustainability score were determined. Data analysis was performed using Statistical Package for the Social Sciences (SPSS) version 25. Results Seven domains scored a mean of ≥ 4. The domains of communications (cross-site mean, 4.5 on a scale of 1-7) and organizational capacity (mean, 4.4) had the highest ratings. Funding stability had the lowest rating (mean, 3.8). The overall mean sustainability score was 4.2. Open-ended responses revealed challenges by program leaders, including implementation difficulties, factors impede planning for NCDs sustainability program, lack of financial, staff support and staff training which are largely consistent with the scaled domains. Conclusions Capacity issues affecting the sustainability of NCDs program in Malaysia are qualitatively similar to other countries. Future work should aim at improving funding stability and integrating evidence-based public health strategies to sustain implemented NCDs program. Key messages Researchers could utilize this tool to assess program design and strategies promoting sustainability during implementation process for long term program sustainment. Investments in leadership support for integrating program evaluation into implementation and greater funding flexibility may enhance sustainability of evidence-based public health program for NCDs.