Increasing the Scale and Adoption of Health Innovations: Practice Models for Public Health

Abstract

The expansion and institutionalisation of effective health interventions is essential to improving population health outcomes, and hence, the study of factors that can assist in scaling up health interventions from small projects or controlled trials into wider policy and practice is important. Sharing lessons learned about scaling up innovative programmes across health has the potential to advance thinking in the field. This chapter describes a 'scalability framework' that can be used to guide the scaling-up of health interventions that is divided into four stages: (1) scalability assessment, involves assessing the suitability of the intervention(s) for scaling-up; (2) develop a scaling-up plan, involves creating a vision of what scaling-up will look like and a compelling case for action; (3) prepare for scale-up, describes how to secure resources and build a foundation of legitimacy and support for scaleup; and (4) scale up the intervention, describes the main tasks that should be addressed during the practice of scaling-up to reach many more people or settings. The framework provides a useful tool to assist health policymakers and practitioners in their efforts to scale up health interventions. Consideration of factors identified in the framework can assist policymakers, practitioners and researchers with cues and processes that may facilitate widespread adoption and maintenance of policies and programmes. Key lessons from the framework are of relevance to scale-up efforts in the educational field, including (1) understanding the nature of the intervention and its effectiveness, (2) understanding the context within which interventions operate, (3) determining the acceptability of the intervention for stakeholders, (4) considering workforce training and capacity building requirements and (5) establishing robust evaluation and monitoring systems.