Scaling Up Evidence-Based Interventions

Simmons, Ruth; Fajans, Peter; Ghiron, Laura

doi:10.1891/9780826186935.0011

Cited by 8 publications

(11 citation statements)

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“…In addition, many policymakers believe that scaling effective health and social care innovations will reduce per capita cost of health care through economies of scale 25,26 . Moreover, policymakers who are concerned about the rapidly increasing inequities within and among countries consider scaling as an effective means to address political and community health inequities 27–30 . These pressing motivations to scale effective innovations are now giving rise to a new interest in the underlying mechanisms at play in scaling, and how to harness them.…”

mentioning

confidence: 99%

Evidence on Scaling in Health and Social Care: An Umbrella Review

CORÔA

Gogovor

Charif³

et al. 2023

Milbank Quarterly

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Policy Points More rigorous methodologies and systematic approaches should be encouraged in the science of scaling. This will help researchers better determine the effectiveness of scaling, guide stakeholders in the scaling process, and ultimately increase the impacts of health innovations. The practice and the science of scaling need to expand worldwide to address complex health conditions such as noncommunicable and chronic diseases. Although most of the scaling experiences described in the literature are occurring in the Global South, most of the authors publishing on it are based in the Global North. As the science of scaling spreads across the world with the aim of reducing health inequities, it is also essential to address the power imbalance in how we do scaling research globally. ContextScaling of effective innovations in health and social care is essential to increase their impact. We aimed to synthesize the evidence base on scaling and identify current knowledge gaps.MethodsWe conducted an umbrella review according to the Joanna Briggs Institute Reviewers’ Manual. We included any type of review that 1) focused on scaling, 2) covered health or social care, and 3) presented a methods section. We searched MEDLINE (Ovid), Embase, PsycINFO (Ovid), CINAHL (EBSCO), Web of Science, The Cochrane Library, Sociological Abstracts (ProQuest), Academic Search Premier (EBSCO), and ProQuest Dissertations & Theses Global from their inception to August 6, 2020. We searched the gray literature using, e.g., Google and WHO‐ExpandNet. We assessed methodological quality with AMSTAR2. Paired reviewers independently selected and extracted eligible reviews and assessed study quality. A narrative synthesis was performed.FindingsOf 24,269 records, 137 unique reviews were included. The quality of the 58 systematic reviews was critically low (n = 42). The most frequent review type was systematic review (n = 58). Most reported on scaling in low‐ and middle‐income countries (n = 59), whereas most first authors were from high‐income countries (n = 114). Most reviews concerned infectious diseases (n = 36) or maternal–child health (n = 28). They mainly focused on interventions (n = 37), barriers and facilitators (n = 29), frameworks (n = 24), scalability (n = 24), and costs (n = 14). The WHO/ExpandNet scaling definition was the definition most frequently used (n = 26). Domains most reported as influencing scaling success were building scaling infrastructure (e.g., creating new service sites) and human resources (e.g., training community health care providers).ConclusionsThe evidence base on scaling is evolving rapidly as reflected by publication trends, the range of focus areas, and diversity of scaling definitions. Our study highlights knowledge gaps around methodology and research infrastructures to facilitate equitable North–South research relationships. Common efforts are needed to ensure scaling expands the impacts of health and social innovations to broader populations.

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mentioning

confidence: 99%

Evidence on Scaling in Health and Social Care: An Umbrella Review

CORÔA

Gogovor

Charif³

et al. 2023

Milbank Quarterly

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“…The next step is the scaling process, aimed at increasing the impact of experiments on a larger number of units (building, quarters, districts, cities). Thanks to this, activities are consolidated and programs are further developed (Simmons, 2007). The implementation of the planned activities takes into account the process of interactive learning of participants and the feedback mechanism, in particular regarding the needs and solutions being developed (their effectiveness or adequacy), whichif necessarywill allow an immediate reaction and possible adaptation of the direction of changes to the needs of a given type of building, district or the entire city.…”

Section: Scaling and Replicating In Other Citiesmentioning

confidence: 99%

“…Kolejnym krokiem jest proces skalowania, mający na celu zwiększenie wpływu eksperymentów na większą liczbę jednostek (budynków, kwartałów, dzielnic, miast). Dzięki temu następuje utrwalenie działań i dalszy rozwój programów (Simmons, 2007). Realizacja przewidzianych działań uwzględnia proces interacyjnego uczenia się partycypantów oraz mechanizm informacji zwrotnej, w szczególności w zakresie potrzeb i opracowywanych rozwiązań (ich skuteczności czy adekwatności), które -w razie potrzeby -pozwolą natychmiast zareagować i ewentualnie dostosować kierunek zmian do potrzeb danego typu budynku, dzielnicy czy całęgo miasta.…”

Section: Skalowanie I Replikowanie W Innych Miastachunclassified

Adapting Cities for Climate Change: Concept of Multi-City Knowledge Transfer in the Field of Decarbonizing Buildings

Pomykała

2024

piF

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The aim of this article is to present assumptions for pilot activities showing how regions can change the way they counteract climate change in the spatial structure of cities. The problem is considered in terms of identifying stakeholder groups and levers of change. An attempt to develop a catalog of levers will allow for the assessment of the usefulness and possibility of transferring pilot activities outside the city context. Further research is also needed to develop appropriate measurement criteria to determine the effectiveness of the strategy. The concept defined its main elements and outlined future directions for its improvement.

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“…Scaling goes beyond simply replicating an innovation; it involves disseminating knowledge, values, processes, and technologies [20] while offering attention to hard-to-reach populations to ensure equity. The policy dimension refers to the speci c objective of institutionalizing or integrating a proven innovation into the existing health system, focusing on institutional capacity building and sustainability [21].…”

Section: Theoretical Perspectives: Complex and Systems Thinkingmentioning

confidence: 99%

Using systems thinking to understand scale-up and sustainability of health innovation: a case study of Seasonal malaria chemoprevention processes in Burkina Faso

Niang

Gagnon

Dupéré

2023

Preprint

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Background: Scale-up and sustainability are often studied separately, with few studies examining the interdependencies between these two processes and the implementation contexts of malaria innovations. Researchers and implementers offer much more attention to the content of innovations, focusing on the technological dimensions and the conditions for expansion. Researchers have often considered innovation a linear sequence in which scaling up and sustainability remained the last stages. Using systems thinking in this manuscript, we aim to analyze the complex scaling and sustainability processes through adopting and implementing Seasonal Malaria Chemoprevention (SMC) in Burkina Faso from 2014 to 2018. Methods: We conducted a qualitative case study involving 141 retrospective secondary data (administrative, press, scientific, tools and registries, and verbatim), spanning 2012 to 2018. We completed these with primary data collected between February to March 2018, as 15 personal semi-structured interviews with SMC's stakeholders and non-participant observations. Processual analysis permitted us to conceptualize scale-up and sustainability processes over time according to different vertical and horizontal levels of analysis and their interconnections. Results: Our results indicated six internal and external determinants of SMC that may negatively or positively influence its scale-up and sustainability in time and space. These determinants are effectiveness; monitoring and evaluation systems; resources (financial, material, and human); leadership and governance; adaptation to the local context; and other external elements. Our results revealed that donors and implementing actors prioritized financial resources over other determinants. In contrast, our study clearly showed that the sustainability of the innovation, as well as its scaling up, depends significantly on the consideration of the interconnectedness of the determinants. Each determinant can concurrently constitute an opportunity and a challenge for the success of the innovation. Conclusion: Our findings highlight the usefulness of the systemic perspective to consider all contexts (international, national, subnational, and local) to achieve large-scale improvement in the quality, equity, and effectiveness of interventions in global health. Thus, complex and systems thinking has made it possible to observe emergent and dynamic innovation behaviors and the dynamics particular to sustainability and scaling up processes.

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Scaling Up Evidence-Based Interventions

Cited by 8 publications

References 0 publications

Evidence on Scaling in Health and Social Care: An Umbrella Review

Evidence on Scaling in Health and Social Care: An Umbrella Review

Adapting Cities for Climate Change: Concept of Multi-City Knowledge Transfer in the Field of Decarbonizing Buildings

Using systems thinking to understand scale-up and sustainability of health innovation: a case study of Seasonal malaria chemoprevention processes in Burkina Faso

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