TITLE:
Community Governance and Sustainability of Health Infrastructures: A Systematic Literature Review
AUTHORS:
Sylvestre Manirakiza, Ildephonse Sindayigaya, Léonidas Ndayizeye, Gabriel Okito Mukabo, Jean Petit Smbananiye, Eric Nsabiyumva, Manirakiza Dismas
KEYWORDS:
Parental Absence, Parental Abandonment, Child Vulnerabilities, School Dropout, Community Governance, Community Participation, Sustainability, Health Infrastructure, Burundi, Developing Countries
JOURNAL NAME:
Open Journal of Social Sciences,
Vol.14 No.9,
September
22,
2026
ABSTRACT: The sustainability of health infrastructures constitutes a major challenge for health systems in developing countries. Despite significant investments, many facilities experience premature degradation or abandonment. Community governance is increasingly presented as a mechanism capable of strengthening local ownership and project sustainability. This systematic review aims to analyze the scientific knowledge relating to the articulation between community governance and sustainability of health infrastructures, in order to identify convergences, divergences and existing gaps, and to formulate a research problem adapted to the Burundian context. A systematic literature search was conducted between April and June 2026 in the following databases: Google Scholar, Scopus, Web of Science, Cairn.info, Persée, PubMed and ScienceDirect. The selection, guided by the PRISMA method, resulted in the analysis of 43 references, supplemented by institutional reports from WHO and UNICEF. The literature reveals a consensus on the positive role of community participation in project ownership and sustainability. Sustainability appears as a multidimensional concept (economic, social, environmental, institutional and community). Community factors explain nearly 40% of observed outcomes in terms of sustainability. However, the precise mechanisms of this influence remain insufficiently documented, and studies specific to Burundi are almost non-existent. The article proposes a conceptual theoretical model of influence mechanisms, as well as operational recommendations for Burundian decision-makers. This review highlights the need for empirical validation of the relationship between community governance and sustainability of health infrastructures in specific contexts, particularly in Burundi. A field survey is essential to identify local influence mechanisms and inform decision-makers.