Skip to main content

Table 3 Synthesis of success factors and barriers to scaling up public health interventions in rank order of mentions

From: Narrative review of models and success factors for scaling up public health interventions

Success factors

Bibliographic references

 Establishing monitoring and evaluation systems

[7, 9, 16, 17, 1922, 2427, 29]

 Costing and economic modelling of intervention approaches

[12, 13, 15, 18, 22, 2426, 28, 30, 31, 44];

 Active engagement of a range of implementers and the target community

[9, 1927, 29];

 Tailoring scale-up approach to local context and use of participatory approaches

[7, 9, 20, 2426, 29, 45];

 Systematic use of evidence

[9, 2327, 29]

 Infrastructure to support implementation such as training,  delivery systems, technical resources

[21, 22, 2428]

 Strong leadership and champions

[9, 19, 2326]

 Political will

[9, 19, 23, 25, 28]

 Well-defined scale-up strategy

[9, 13, 19, 21, 2326]

 Strong advocacy

[9, 23, 28, 29]

 Flexible responses to human resource constraints

[18, 25, 26, 46]

 Formative research to ensure appropriate intervention design

[23, 2527]

 Equity of intervention delivery and monitoring intended and unintended consequences across socio-demographic profiles

[17, 25, 26, 28]

 Effective communication strategy

[18, 21, 23, 27]

 Effective governance and coordination

[9, 26, 29]

 Clear role definition and delineation

[17, 23, 26]

 Keeping the intervention model simple

[9, 24, 26]

 Financing models

[20, 21, 28]

 Programmes are visible, publicised and effectively packaged

[19, 25]

 Developing strategies for integration into existing services

[19, 21, 26]

Barriers

 

 Not adapting intervention approaches to the local context

[1820, 24]

 Intervention costs and other economic factors

[12, 22, 25, 32]

 Lack of human resources

[13, 18, 19]

 Resistance to the introduction of new practices due to capacity constraints

[18, 19, 26]

 Insufficient investment in implementation infrastructure including training, monitoring and evaluation systems

[17, 18, 45]

 Staff recruitment and staff turnover

[18, 19, 46]

 Lack of political will

[9, 32]

 Traditional research funding processes are not flexible enough to support evaluation of scale up

[19]

 Leadership changes amongst implementation agencies

[19]

 Poor engagement with stakeholders and thought leaders

[52]

 Poor role delineation

[32]

 Maintaining quality and consistency of health interventions at scale [18]

[18]