Wednesday, June 29, 2011

[EQ] Scaling Up Global Health Interventions: A Proposed Framework for Success

Scaling Up Global Health Interventions: A Proposed Framework for Success

Gavin Yamey - Evidence-to-Policy Initiative, Global Health Group, San Francisco, CA, USA

PLoS Med 8(6): e1001049. doi:10.1371/journal.pmed.1001049

Published: June 28, 2011

Available online at:


“…..The rise in international aid to fund large-scale global health programs over the last decade has catalyzed interest in improving the science of scale-up.

This Essay draws upon key themes in the emerging science of large-scale change in global health to propose a framework for explaining successful scale-up.

Success factors for scaling up were identified from interviews with implementation experts and from the published literature.

These factors include the following: choosing a simple intervention widely agreed to be valuable, strong leadership and governance, active engagement of a range of implementers and of the target community, tailoring the scale-up approach to the local situation, and incorporating research into implementation.


…….In this Essay, I draw upon key themes in this emerging science to propose a framework for explaining successful scale-up. This framework is aimed at planners of scale-up processes to use in thinking about strategies for implementing a new program, policy, or intervention to scale.


The term “scaling up” is now widely used in the public health literature, but there is no agreed definition. The term is primarily used, say Mangham and Hanson, to describe “the ambition or process of expanding the coverage of health interventions” [6], a working definition that I use in this article….”


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