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Sub-national and district management: Scaling up services

Overview

• Scaling up health services: challenges and choices
  2008, Health Services Delivery Technical Brief No.3
  Doing something in a big way to improve some aspect of a population’s health; it can be scaling up inputs; outputs (access, scope, quality, efficiency); outcomes (coverage, utilization) or impact (reducing morbidity or mortality); sustainability, equity external consequences; needs more resources, better laws, better management and more demand from clients.
  (19 pages, pdf 256kb)
• Rehabilitating the Workforce: the key to scaling up MNCH
  World Health Report 2005
  Planned expansion of the workforce; rehabilitate productivity and morale; confront the remuneration issue; HR a matter of national importance
  (4 pages, pdf 500kb)
• Scaling up health workforce production
  2006
  The magnitude of the health workforce crisis in Africa; scaling up health workforce production; improving production capacity; producing a responsive skill mix; establishing a regulatory framework for professional training and practice; implications of moving forward
  (16 pages, pdf 327kb)
• Scaling up health service delivery: from pilot innovations to policies and programmes
  Edited by Ruth Simmons, Peter Fajans, and Laura Ghiron, 2007, WHO and ExpandNet
  Ways to increase the impact of health service innovations that have been tested in pilot or experimental projects so as to benefit more people and to foster policy and programme development on a lasting, sustainable basis; a conceptual framework for thinking about scaling up; case-studies from Africa, Asia and Latin America; the potential for expansion considered from the very inception of pilot or experimental projects.
  (204 pages, pdf 1.4MB)
• Constraints to Scaling up Health
  K. Wyss, D. D. Moto, B. Callewaert, 2002, Commission on Macroeconomics and Health
  When scaling up health interventions, activities have to put special emphasis on systemic approaches, on the production of health services, and measures of performance, development of infrastructures must follow the development of human resources. Improvements in physical access must evolve in parallel with better quality of care. continuous training in management skills; systems of supervision and assessment based on participatory elaboration of quality standards; Contracting work to the private sector offers an opportunity to overcome the scarcity of human resources in the public sector. However, this requires the regulation of the private sector.
  (41 pages, pdf 106kb)
• Best Practices in Scaling Up: Introduction
  2007, John Snow Inc.
  What is scaling up; types of scaling up: quantitative, functional, political, organizational; how can scaling up be achieved?
  (4 pages, pdf 272kb)
• Scaling up Logistics Management Information Systems in Health Commodity Supply Chains
  Gregory Roche and Barbara Felling, 2006, John Snow Inc.
  Three country case studies: 5 step process to scale up commodities supply chains to increase the number and types of products provided; why commodity scale up is important; how logistics management information systems must be developed to support extended services;
  (8 pages, pdf 556kb)
• Achieving Skilled Attendance for All; A Synthesis of Current Knowledge and Recommended Actions for Scaling Up
  Sandra MacDonagh, 2005, UK Department for International Development
  Critical steps; developing and empowering skilled attendants; creating an enabling environment for skilled attendance; approaches to enable change; commitment to equity and human rights; information gaps
  (40 pages, pdf 282kb)
• Nine Steps for Developing a Scaling-Up Strategy
  2009, WHO and ExpandNet
  Framework for scaling up; 4 principles for scaling up:
    1. Systems thinking
    2. A focus on sustainability
    3. Assessing the attributes of success
    4. Respect for human rights
  (33 pages, pdf 748kb)
• A Guide for Fostering Change to Scale Up Effective Health Services
  pdf, 537kb
  2007, WHO and USAID
  Examples proven approaches to effective change; principles that are fundamental to effective change; “how-to” steps for successful change; key challenges related to the steps and recommending strategies, tools, or approaches for meeting those challenges;
  (56 pages, PDF 526kb)
• Scaling Up—From Vision to Large-scale Change: A Management Framework for Practitioners
  Larry Cooley and Richard Kohl, Edited by Rachel Glass, 2005, Management Systems International
  Begin with a plan; create a vision; assess scalability; fill information gaps; establish preconditions and implement a scaling-up process; legitimize change; build a constituency; realign and mobilize resources; modify and strengthen organizations ; coordinate action; track performance and maintain momentum; examples Mexico and Nigeria
  (64 pages, pdf 1MB)

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