Aguaconsult was contracted to design and implement a Sustainability Check review of field programs in the three pilot countries of the International H2O Alliance Partnership (Ghana, Dominican Republic, and The Philippines) in order to assess the likelihood of long-term and sustained use of WASH infrastructure and services (as well as the successful adoption of necessary hygiene behaviours). In partnership, BPD undertook and assessment of the International H20 Collaboration alliance partnership relationships to date and provided a framework for the next phase of partnership activity, both at international, and country levels. The sustainability check assignment, based on key factors associated with long-term sustainability, involved the design and piloting of a sustainability check tool and the fielding of three in country survey teams, with multiple staff on location, managed by in-country coordinators. Coordinated from the UK office, the in-country teams carried out pilot testing in multiple settings to produce a working model of the tool, which was then rolled out across the alliance activity sites. The survey produced a picture of the strengths and weaknesses of the various interventions in combination with survey and desktop research.