Many health programmes rely on external funding, technical assistance, or partner support during implementation. While these investments often produce significant gains, sustaining progress over time requires strong local systems that can continue delivering services and managing programmes independently.

Transitions can be complex, involving changes in governance, financing, management structures, workforce responsibilities, and accountability mechanisms. Without careful planning and strong local ownership, gains achieved through investments may be difficult to sustain.

There is therefore a need for evidence that helps policymakers and stakeholders understand how successful transitions can be designed, managed, and institutionalised.