Donor-funded Integrated Community Case Management (iCCM) was implemented to expand access to underserved children with diarrhea, malaria and pneumonia diseases in hard-to-reach communities in Niger State. Sustaining this intervention beyond donor funding is critical for lasting impact. The study assessed the proportion of Community Oriented Resource Persons (CORPs) still delivering iCCM services one year after donor support ended and examined policy measures taken to support program sustainability. This cross-sectional mixed-methods study involved quantitative surveys and qualitative interviews. A random sample of 291 trained CORPs in intervention communities was surveyed on service delivery status one-year post-donor funding. Key stakeholders were interviewed using the Program Sustainability Assessment Tool to explore policy actions taken to sustain the program beyond donor funding period. Majority 270 (92.8%) of the CORPs were willing but unable to continue to provide care for sick children as only 62 (21.3%) of the CORPs continued providing iCCM related services one-year after donor funding ended. Most 216 (94.3%) of the CORPs cited lack of essential commodities, medicines, and supervision required to sustain service delivery. Stakeholders acknowledged efforts to sustain the program but identified insufficient political and financial support to maintain essential resources as key barriers. Most CORPs ceased services mainly due to commodity shortages and inadequate supervision, with limited political and funding backing contributing to program decline. For sustainable community-based child health interventions, integrating iCCM into existing primary healthcare systems, coupled with committed political will and secure funding mechanisms, is essential.

Yahaya Mustapha Makanta is a Consultant Public Health Physician, researcher, and health systems expert with extensive experience in public health program implementation, epidemiology, and primary healthcare system strengthening. He currently serves as Director, Planning Research and Statistics at Niger State Primary Health Care Development Agency and leads several strategic health initiatives, including PHC Leadership Challenge and Maternal and Neonatal Mortality Reduction programs. A Fellow of the National Postgraduate Medical College of Nigeria, he has contributed significantly to healthcare workforce development, public health emergency initiatives, health systems resilience, and community health interventions through leadership, research, consultancy, and national-level technical engagements.