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Table 1 DSF tenets, SMI results, and threats to sustainability

From: Results-based aid with lasting effects: sustainability in the Salud Mesoamérica Initiative

DSF tenets SMI results Threats to sustainability
Not optimized before implementation (Tenet 1) Evolving design  
Continually improves and ongoing learning (Tenet 2) Ongoing feedback (Tenet 3) Evidence-based practices Sector-wide approach (quality improvements, capacity building, health information systems, knowledge-sharing)  
Voltage drop not inevitable (Tenet 4) Culture of prioritizing healthcare Policy dialogue Scale-up of interventions Possible transient culture of prioritizing healthcare
Fit between program and setting (Tenet 5) Aligns with national needs Health systems strengthening  
Organizational learning (Tenet 6) Problem-solving capacity Personnel turnover
Ongoing stakeholder involvement (Tenet 7) Partnerships, including regional approach and RBA model Dissipation of reputational risk and donor-government financial partnerships