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. 2022 Aug 5;22:1001. doi: 10.1186/s12913-022-08354-y

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© The Author(s) 2022

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

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Fig. 2 — The PERFORM2Scale theory of change for scaling up management strengthening at the district level to support the achievement of universal health coverage. AR: action research; DG: district group; DHMT: district health management team; HSO: horizontal scale-up outcome; MSI: management strengthening intervention; NSSG: national scale-up steering group; RT: resource team; UHC: universal health coverage; VSO: vertical scale-up outcome. The PERFORM2Scale consortium realized that this ToC looks linear and omits some arrows; however, it was decided not to present all of them and focus on the main pathways of change. ToC adaptations are indicated in dotted lines for arrows, in underlined text and in (new) assumptions having a white instead of a black background