From: Narrative review of models and success factors for scaling up public health interventions
Model/framework | Key components | Focus area | Process of development | Context | Bibliographic references |
---|---|---|---|---|---|
Scalability considerations | Scalability with a focus on the following: | Health promotion: generic | Literature review and expert Delphi process | High-income country | [25] |
➢ Effectiveness | |||||
➢ Reach and adoption | |||||
➢ Human, technical and organisational Resources | |||||
➢ Costs | |||||
➢ Intervention delivery | |||||
➢ Contextual factors | |||||
➢ Appropriate evaluation approaches | |||||
Scaling up population health interventions: guide, New South Wales Ministry of Health | A 4-step process for scaling up interventions: | Public health: generic | Literature review and expert Delphi process | High-income country | [26] |
➢ Step 1. Scalability assessment: to assess the suitability of the intervention/s for scaling up | |||||
➢ Step 2. Develop a scaling up plan: create a vision of what scaling up will look like and a compelling case for action | |||||
➢ Step 3. Prepare for scaling up: securing resources and building a foundation of legitimacy and support for the scaling up plan | |||||
➢ Step 4. Scale up: the main tasks that should be addressed during scale up | |||||
9 steps to scaling up, WHO ExpandNet | ExpandNet framework involves 9 steps: | Health services and public health: generic | Literature review and interviews | Global health | |
➢ Planning actions to increase the scalability of the innovation | |||||
➢ Increasing the capacity of the user organisation to implement | |||||
➢ Assessing the environment and planning actions to increase the potential for success | |||||
➢ Increasing the capacity of the resource team to support scaling up | |||||
➢ Making strategic choices to support vertical scaling up (institutionalisation) | |||||
➢ Making strategic choices to support horizontal scaling up (expansion/replication) | |||||
➢ Determining the role of diversification | |||||
➢ Planning actions to address spontaneous scaling up | |||||
➢ Finalising the scaling-up strategy and identifying next steps | |||||
Scaling up management (SUM) framework | Includes 3 key steps: | Health services and public health: generic | Literature and interviews | Global health | [24] |
➢ Step 1: developing a scaling up plan | |||||
➢ Step 2: establishing the preconditions for scaling up | |||||
➢ Step 3: implementing the scaling up process based on the identification of factors that can promote extension and sustainability | |||||
Scale up of exclusive breastfeeding | Involves the following steps: | Health services and public health: breastfeeding | Systematic review | Global health | [23] |
➢ Assess situation, create a policy environment conducive to action | |||||
➢ Define roles, relationships and responsibilities of all partners | |||||
➢ Establish agreements | |||||
➢ Review technical support | |||||
➢ Define programme strategy | |||||
➢ Mobilise resources | |||||
➢ Provide training and technical assistance | |||||
➢ Develop and use monitoring and evaluation systems | |||||
➢ Monitor coverage and quality | |||||
➢ Measure impact and cost | |||||
➢ Provide for testing novel approaches and continuing innovation | |||||
Scaling up global health interventions: framework for success | Describes 6 components of the scaling up process: | Health services and public health | Literature review and interviews with experts | Global health | [9] |
➢ Attributes of the specific tool or service being scaled up | |||||
➢ Attributes of the implementers | |||||
➢ Chosen delivery strategy | |||||
➢ Attributes of the ‘adopting’ community | |||||
➢ Socio-political context and research context | |||||
Breastfeeding gear model | Eight interrelated elements: | Health services and public health | Literature review, interviews and focus groups | Global health | [27] |
➢ Advocacy | |||||
➢ Political will | |||||
➢ Legislation and policies | |||||
➢ Funding and resources | |||||
➢ Training and delivery | |||||
➢ Promotion | |||||
➢ Research and evaluation | |||||
➢ Coordination and goals monitoring | |||||
The framework suggests successful multiple feedback loops and several potential paths are required to achieve intended innovation |