Resilience and Sustainability Performance of Health and Sanitation Projects in Uganda

ABSTRACT Sustainability challenges continue to undermine the long‐term effectiveness of health and sanitation projects in many developing countries, particularly where projects are exposed to institutional, environmental, and operational uncertainties. This study examined the influence of resilience on the sustainability performance of health and sanitation projects in Central Uganda. The study employed a cross‐sectional quantitative research design using data collected from 520 respondents across 86 health and sanitation projects located in Kampala, Wakiso, and Mukono districts. Data were analyzed using PLS‐SEM to examine the predictive relationships between resilience and sustainability performance. The findings reveal that resilience positively and significantly influences sustainability performance in health and sanitation projects. Specifically, the results indicate that shock absorption capacity, adaptability, redundancy in operations, and learning and innovation all have significant positive effects on sustainability performance, suggesting that projects with stronger resilience capabilities are more likely to achieve sustainable economic efficiency, improved social outcomes, and responsible environmental management. The study suggests that strengthening resilience mechanisms such as risk management systems, adaptive governance structures, backup operational systems, and continuous learning practices can significantly enhance the sustainability of health and sanitation initiatives. Integrating resilience‐oriented strategies into project planning and management may therefore improve the ability of development projects to withstand disruptions while maintaining sustainable service delivery. This study contributes to the literature by addressing a critical research gap concerning the role of resilience in enhancing sustainability performance in health and sanitation projects, particularly within developing country contexts.