From: Narrative review of models and success factors for scaling up public health interventions
Success factors | Bibliographic references |
Establishing monitoring and evaluation systems | |
Costing and economic modelling of intervention approaches | |
Active engagement of a range of implementers and the target community | |
Tailoring scale-up approach to local context and use of participatory approaches | |
Systematic use of evidence | |
Infrastructure to support implementation such as training, delivery systems, technical resources | |
Strong leadership and champions | |
Political will | |
Well-defined scale-up strategy | |
Strong advocacy | |
Flexible responses to human resource constraints | |
Formative research to ensure appropriate intervention design | |
Equity of intervention delivery and monitoring intended and unintended consequences across socio-demographic profiles | |
Effective communication strategy | |
Effective governance and coordination | |
Clear role definition and delineation | |
Keeping the intervention model simple | |
Financing models | |
Programmes are visible, publicised and effectively packaged | |
Developing strategies for integration into existing services | |
Barriers | |
Not adapting intervention approaches to the local context | |
Intervention costs and other economic factors | |
Lack of human resources | |
Resistance to the introduction of new practices due to capacity constraints | |
Insufficient investment in implementation infrastructure including training, monitoring and evaluation systems | |
Staff recruitment and staff turnover | |
Lack of political will | |
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] |