The Global Scaling Up Handwashing project emphasizes the need to incorporate sustainability from the very start of intervention activities to ensure the changes achieved continue past the completion of the project.  The factors influencing the likelihood of handwashing programs achieving sustainability vary from country to country, but typically include the need to build institutional ownership and bolstering implementation capacities. Performance monitoring is essential as it can provide evidence to refine programming to improve impact and sustainability. This sustainability module includes a presentation detailing these concepts, as well as reports that address sustainability as a key component of handwashing programs.