Applying ExpandNet’s Systematic Approach to Scaling Up in an Integrated Population, Health and Environment Project in East Africa

Omimo, Antony; Taranta, Dorah; Ghiron, Laura; Kabiswa, Charles; Aibe, Sono; Kodande, Millicent; Nalwoga, Caroline; Mugaya, Samuel; P, Onduso

doi:10.3390/socsci7010008

Cited by 8 publications

(10 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The body of literature on scale-up in implementation research is growing, but we found little evidence that the methodological challenges we have documented here have been fully addressed. Of the four scalability assessment tools we reviewed, two emerged from communities of practice (Cooley and Kohl, 2006; ExpandNet WHO, 2011), and experiences of moving from projects to programmes using the ExpandNet scalability assessment tool are increasingly being documented (Ghiron et al , 2014; Keyonzo et al , 2015; Omimo et al , 2018). Implementation research has also documented intervention adaptation to aid scale-up of quality improvement interventions using the Institute for Healthcare Improvement's approach (Twum-Danso et al , 2014; Barker et al , 2016).…”

Section: Discussionmentioning

confidence: 99%

Assessing scalability of an intervention: why, how and who?

Zamboni

Schellenberg

Hanson

et al. 2019

Health Policy and Planning

104

View full text Add to dashboard Cite

Public health interventions should be designed with scale in mind, and researchers and implementers must plan for scale-up at an early stage. Yet, there is limited awareness among researchers of the critical value of considering scalability and relatively limited empirical evidence on assessing scalability, despite emerging methodological guidance. We aimed to integrate scalability considerations in the design of a study to evaluate a multi-component intervention to reduce unnecessary caesarean sections in low- and middle-income countries. First, we reviewed and synthesized existing scale up frameworks to identify relevant dimensions and available scalability assessment tools. Based on these, we defined our scalability assessment process and adapted existing tools for our study. Here, we document our experience and the methodological challenges we encountered in integrating a scalability assessment in our study protocol. These include: achieving consensus on the purpose of a scalability assessment; and identifying the optimal timing of such an assessment, moving away from the concept of a one-off assessment at the start of a project. We also encountered tensions between the need to establish the proof of principle, and the need to design an innovation that would be fit-for-scale. Particularly for complex interventions, scaling up may warrant rigorous research to determine an efficient and effective scaling-up strategy. We call for researchers to better incorporate scalability considerations in pragmatic trials through greater integration of impact and process evaluation, more stringent definition and measurement of scale-up objectives and outcome evaluation plans that allow for comparison of effects at different stages of scale-up.

show abstract

Section: Discussionmentioning

confidence: 99%

Assessing scalability of an intervention: why, how and who?

Zamboni

Schellenberg

Hanson

et al. 2019

Health Policy and Planning

104

View full text Add to dashboard Cite

show abstract

“…Active aging here discussed has identified changes in the quality of life and socio-economic conditions of older adults (Sidorenko and Zaidi 2018) from the health dimension in particular. Age function related organizations such as the National Health Insurance Authority, Ministry of Gender, Children and Social Protection, NPA and a host of others need to collaborate to build genuine partnerships across sectors (Omimo et al 2018). Increasingly, the effectiveness of delivery agencies is measured in terms of their outputs.…”

Section: Discussionmentioning

confidence: 99%

“…. (Omimo et al 2018) all stakeholders namely governments, policy organizations, social security practitioners and healthcare providers to work together to proactively increase older adults' universal access to healthcare and delivery. Such an act may also take into account the development of financial vehicles that may, for instance, facilitate hedging against increases in longevity.…”

Section: Conclusion and Policy Recommendationsmentioning

confidence: 99%

Leveraging Healthcare Opportunities for Improved Access among Ghanaian Retirees: The Case of Active Aging

Dovie

2018

Social Sciences

View full text Add to dashboard Cite

This paper is a policy brief with targeted interviews of older adults in urban Ghana with recommendations for future healthcare policy. Using qualitative explorative approach, the scope of the research is to examine opportunities that focus on healthy aging in order to enhance healthcare infrastructure in Ghana in preparation for an increased number of older adults. The paper mainly finds that improved healthcare solicitation and the social world of older adults are intricately linked. The healthcare needs of older adults are met through diverse mechanisms-the Pensioners' Medical Scheme and ceragim concept. These depict a transformation in healthcare access and delivery with implications for wider healthcare, solidarity and efficiency. Active ageing strategies therefore facilitate the provision of supplementary healthcare access by seeking health solutions independently, including the creation of awareness about the challenges and the concomitant health resource opportunities for older adults. These have the tendency for the development of an acumen for healthcare-related resilience. I argue that health-related challenges depict opportunities for smarter solutions and mutual growth, further showing that aging is gain and a human development issue that fosters the emergence of an integrated healthcare system. Crucially, the paper reveals that health-related challenges are used to leverage entry and participation in the healthcare products' market and by extension access to quality and holistic healthcare services. This encompasses innovative healthcare infrastructural resources that Ghanaian older adults patronize. These health resources are worth pursuing and may need to be incorporated into the National Policy on Ageing, with envisaged universal coverage in focus.

show abstract

“…Many publications in the last twelve years have assessed the determinants of scale-up success and laid out frameworks and practical guidance to support the scale-up process (Simmons et al, 2007;Hartmann & Linn, 2008;ExpandNet & World Health Organization, 2009, 2010, 2011Yamey, 2011;Chandy & Linn, 2011;Chandy et al, 2013;Cooley & Linn, 2014;Milat et al, 2015;Barker et al, 2016;Milat et al, 2016;Management Systems International, 2016;Spicer et al, 2018;Bulthuis et al, 2020). Other publications have focused on sharing in-country project experience of scale-up activities (Ghiron et al, 2014;Igras et al, 2014;Spicer et al, 2014;Keyonzo et al, 2015;Aichatou et al, 2016;Fajans & Simmons, 2016;Omimo et al, 2018;Mai et al, 2019;Benevides et al, 2019;Oku, 2019;Expand-Net, 2021). These have all contributed to shifting the global health and development paradigm away from more conventional project approaches (Keyonzo et al, 2015) to ones that use knowledge about what works for scale-up to shape the introduction of new interventions and their subsequent expansion and institutionalization.…”

Section: Introductionmentioning

confidence: 99%

Promoting Scale-Up Across a Global Project Platform: Lessons from the Evidence to Action Project

Ghiron

Ramirez-Ferrero

Badiani

et al. 2021

Glob Implement Res Appl

Self Cite

View full text Add to dashboard Cite

The USAID-funded flagship family planning service delivery project named Evidence to Action (E2A) worked from 2011 to 2021 to improve family planning and reproductive health for women and girls across seventeen nations in sub-Saharan Africa using a “scaling-up mindset.” The paper discusses three key lessons emerging from the project’s experience with applying ExpandNet’s systematic approach to scale up. The methodology uses ExpandNet/WHO’s scaling-up framework and guidance tools to design and implement pilot or demonstration projects in ways that look ahead to their future scale-up; develop a scaling-up strategy with local stakeholders; and then strategically manage the scaling-up process. The paper describes how a scaling-up mindset was engendered, first within the project’s technical team in Washington and then how they subsequently sought to build capacity at the country level to support scale-up work throughout E2A’s portfolio of activities. The project worked with local multi-stakeholder resource teams, often led by government officials, to equip them to lead the scale-up of family planning and health system strengthening interventions. Examples from project experience in the Democratic Republic of the Congo, Kenya, Nigeria, and Uganda illustrating key concepts are discussed. E2A also established a community of practice on systematic approaches to scale up as a platform for sharing learning across a variety of technical agencies engaged in scale-up work and to create learning opportunities for interacting with thought leaders around critical scale-up issues.

show abstract

Applying ExpandNet’s Systematic Approach to Scaling Up in an Integrated Population, Health and Environment Project in East Africa

Cited by 8 publications

References 6 publications

Assessing scalability of an intervention: why, how and who?

Assessing scalability of an intervention: why, how and who?

Leveraging Healthcare Opportunities for Improved Access among Ghanaian Retirees: The Case of Active Aging

Promoting Scale-Up Across a Global Project Platform: Lessons from the Evidence to Action Project

Contact Info

Product

Resources

About