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Governance 

Plant health clinics are owned by the organisations that run them, although their management will also depend on any conditions set by external funding. National coordination is usually through the Ministry of Agriculture or delegated authority. Regional departments of agriculture may also play an important role in coordinating clinics. Under the Plantwise programme, 19 countries have established a national governance body as part of a general plant health system approach. 

Evidence of impacts, sustainability, and scalability 

Several studies of PHCs have found positive trends in increased crop production and income earned (8)
Brubaker, J., Danielsen, S., Olupot, M., Romney, D. and Ochatum, N. 2013. CABI-WP6-impact-of-plant-clinics-teso-uganda.pdf: Teso, Uganda. Working Paper 6. Wallingford, UK: CABI.

Bentley, J., Boa, E., Almendras, F., Franco, P., Antezana, O., Díaz, O., Franco, J. and Villarroel, J. 2011. How farmers benefit from plant clinics: An impact study in Bolivia. International Journal of Agricultural Sustainability: 393–408.
. Attributing these key changes to PHCs alone is difficult. High farmer satisfaction is reported from several countries and anecdotal evidence attributes yield gains to clinic visits. Plant doctor knowledge and confidence has improved substantially following training under the Plantwise programme, with nearly 3,000 having attended courses. 

Local funding in Pakistan, Sri Lanka, and Malawi, buoyed by positive feedback from initial PHCs, has seen the combined number for these three countries rise steadily from 147 in 2013 to 529 in 2015. 

Sustainability depends on organisations incorporating PHCs into their everyday activities and embedding them in a plant health system. Local commitment plus strategic national support is the key to maintaining regular and high-quality services. For example, strong central support in Kenya has created a thriving network of PHCs. It is generally more difficult to maintain such networks when management of public extension services is devolved to regions. 

Plantwise monitors progress using a sustainability roadmap, combining scores for key elements such as plant clinic operations, stakeholder linkages, use of data, and monitoring and evaluation (9). In future this tool will help to identify corrective actions needed to strengthen sustainability.