How sustainable are self-help interventions in the post-funding period? Qualitative findings from integrated leprosy communities in Nigeria

BACKGROUND: Time-limited, externally funded self-help groups (receiving training, equipment and access to seeds) are typically evaluated during the funding period. However, their sustainability beyond this phase remains understudied. METHODS: This retrospective qualitative study explored the post-funding sustainability of two 6-y self-help interventions (2013-2019) for groups in integrated leprosy communities in central Nigeria. Semi-structured interviews were conducted with 40 stakeholders (beneficiaries, implementers and funders) and supplemented by document analysis. RESULTS: Findings revealed that most activities ceased after funding ended, with limited evidence of sustained benefits. In one community, sewing initiatives persisted, while the other showed no lasting impact. Challenges included inadequate maintenance of provided equipment (e.g. sewing machines, tricycles) and systemic barriers such as insecure land tenure and limited educational access. CONCLUSIONS: The study highlights the fragility of externally funded self-help models in marginalised communities. Sustainability requires integration with broader economic systems and infrastructure support. Funders should prioritise long-term planning alongside short-term interventions.