Table 2.
Factors considered in scale-up frameworks
| Features | ExpandNet (Simmons et al., 2007; McCannon and Perla, 2008; ExpandNet WHO, 2009, 2010) | Management Systems International (Cooley and Kohl, 2006, 2012) | Yamey (2011) | Implementing Best Practices Consortium (2007) | Massoud (2004) | Barker et al. (2016) | Bradley et al. (2012) | Cambon et al. (2013) | Spicer et al. (2014), Massoud (2004) | Milat et al. (2016) |
|---|---|---|---|---|---|---|---|---|---|---|
| Attributes of the innovation/intervention | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | |
| Credibility of model (evidence base for innovation) | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | |||
| Observability of results (impact or effectiveness) | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ||||
| Relevance to concern of potential adopters | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ||
| Relative advantage over existing practice | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ||||
| Simplicity or ease of adoption | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | |||
| Model testable and adaptable | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | |||
| Affordability or cost-effectiveness | ✓ | ✓ | ✓ | ✓ | ||||||
| Acceptability | ✓ | ✓ | ✓ | ✓ | ✓ | |||||
| Aligned and harmonized with existing government health system or programme | ✓ | ✓ | ✓ | ✓ | ||||||
| Attributes of implementers | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ |
| Leadership and credibility | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | |||
| Use of champions | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ||||
| Networking, collaboration and partnership (to foster buy-in) | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ||
| Capacity to support scale-up (skills, size, resources and experience) | ✓ | ✓ | ✓ | |||||||
| Stability or grant size and length | ✓ | ✓ | ||||||||
| Culture of urgency and persistence | ✓ | ✓ | ||||||||
| Provision of capacity building for adopting stakeholders | ✓ | ✓ | ✓ | |||||||
| Attributes of adopting community | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ |
| Clarity on who user organizations are, their needs and concerns | ✓ | ✓ | ✓ | ✓ | ✓ | |||||
| Capacity for scale-up (staffing, skills, logistic system and other) | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ||||
| Supportive organizational culture and leadership | ✓ | ✓ | ||||||||
| Capacities for data collection and reporting systems | ✓ | ✓ | ||||||||
| Timing or window of opportunity | ✓ | |||||||||
| Learning systems | ✓ | ✓ | ✓ | |||||||
| Engaged, activated community and institutional buy-in | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ||||
| Extent to which decision-making is data-driven | ✓ | |||||||||
| Socio-political context | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | |
| Political will | ✓ | ✓ | ✓ | ✓ | ||||||
| Country ownership and institutional support | ✓ | ✓ | ✓ | ✓ | ✓ | |||||
| Stakeholder analysis | ✓ | ✓ | ✓ | ✓ | ||||||
| Assessment of policy priorities, government systems and political climate | ✓ | ✓ | ✓ | |||||||
| Analysis of inter-sectoral collaboration (if relevant) | ✓ | |||||||||
| Policy-legal environment (financial, economic or procedural incentives) | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ||||
| Attitudes, values, priorities and motivations of health workers and communities | ✓ | ✓ | ✓ | |||||||
| Scale-up strategy | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | |
| Create a vision for scale-up | ✓ | ✓ | ✓ | ✓ | ✓ | |||||
| Define scalable unit | ✓ | ✓ | ||||||||
| Tailoring scale-up to context | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | |||
| Strategic choices inform scale-up plan | ✓ | ✓ | ✓ | |||||||
| Phased approaches to scale-up or ongoing refinement for sustainability | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ||||
| Alignment or integration in system or service | ✓ | ✓ | ✓ | ✓ | ||||||
| Advocacy and communication | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | |||
| Resource mobilization and alignment | ✓ | ✓ | ✓ | |||||||
| Scale-up plan | ✓ | ✓ | ✓ | |||||||
| Ongoing M&E and dissemination of learning | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ |