Table 4.

Summary of key findings

	Outcomes	Factors affecting outcomes
1a	Scale-up structures established and functioning: NSSGs	High workload of NSSG members NSSG viewed as parallel structure Power dynamics affected functioning Alternative approaches employed when NSSGs not functioning
1b	Scale-up structures established and functioning: RTs	Stability of the RT Expert knowledge and seniority of RT Research team support to facilitate MSI
2	Horizontal scale-up was achieved	Plan for horizontal scale-up Support for MSI facilitation Locally appropriate adaptations to the MSI COVID-19—priority given to pandemic control
3	Management strengthened when MSI scaled-up	Multiple MSI cycles Research team role
4	Country scale-up strategies were developed	Vision and clarity Loss of momentum with COVID-19 emergence
5	Some integration of MSI into policies and practice in Uganda and Malawi, but no financial support	Champions for scaling-up the MSI Generating and sharing robust quantitative and costing data early Power and politics—aligning with people with power and with political interests