Management for health services delivery

Sub-national and district management: Scaling up services

Country experiences

  • Equity and Fair Process in Scaling Up Antiretroviral Treatment: Potentials and Challenges in The United Republic of Tanzania
    2006, WHO, GTZ and Tanzania Ministry of Health
    Analysis of decision-making in the scale-up of ART, using the concept of fair process; targets for ART scaling-up; site selection of ART centres; eligibility criteria for patient selection and priority for special groups; drug protocols and procurement decisions; allocation of human resources for ART; cost-sharing or free access to ART
    (28 pages, pdf 280kb)
  • Scaling Up for Better Health in Cambodia
    Christopher Lane, 2007, World Health Organization and the Ministry of Health, Cambodia
    This report analyses the barriers to scaling up health service provision in Cambodia with a view to attaining the health millennium development goals (MDGs). It focuses primarily on financial and administrative impediments, but also considers the extent to which human resources and the institutional framework pose binding constraints to achieving the MDGs.
    (52 pages, pdf 583kb)
  • Guatemala, Pro Redes Salud: Rapid scale-up of primary health care through NGOs
    Elizabeth Burleigh, 2006, John Snow Inc.
    Process used to scale up primary health care programs in the Guatemalan highlands; how high quality services can be extended to thousands of rural residents through NGO networks; steps used to scale-up; what worked and what was learned.
    (8 pages, pdf 721kb)
  • Using a Simple Survey Method to Scale Up Evidence-Based Decision Making at the District Level in Uganda
    pdf, 754kb

    Xavier Nsabagasani, Joseph Mabirizi, Samson Kironde and Nosa Orobaton, 2007, John Snow Inc.
    Case study, quality assurance sampling methodology for data collection and analysis; accurate data available for planning; budgets more accurately reflect districts' needs, and district performance can be measured and health services improved; what worked and what was learned;
    (8 pages, pdf 738kb)
  • When Scaling Up is the Only Alternative: Experience with Workplace HIV Programs in Zambia
    Mutinta Nyumbu, Rose Musumali Lungu, Simon Mutonyi and Chilufya Mwaba, 2006, John Snow Inc.
    The case study highlights how workplace-based programs matter, strategies and steps used to scale-up and results from Zambia; what worked and lessons learned;
    (8 pages, pdf 982kb)
  • The Ghana Community-based Health Planning and Services Initiative for Scaling Up Service Delivery Innovation
    Frank K Nyonator, J Koku Awoonor-Williams, James F Phillips, Tanya C Jones and Robert A Miller, 2005, Health Policy and Planning; 20(1): 25–34
    Evidence-based policy development; bridges the gap between research and programme implementation; the Community-based Health Planning and Services (CHPS) Initiative; mobilize volunteers, resources and cultural institutions for supporting community-based primary health care. This paper describes the implementation and the principles of scaling up organizational change.
    (10 pages, pdf 271)
  • Guidelines for scaling-up the 100% condom use programme: Experience from Cambodia
    2003, WHO Regional Office for the Western Pacific
    1. Advocacy on the acceptability, effectiveness and feasibility of the strategy; 2. Development of policy and national guidelines, including the production of an implementation handbook; 3. Development of a scaling-up plan; 4. Support for implementation, including study visits to the demonstration site, training and capacity building, and field support; and 5. Ensure the availability and accessibility of condoms.
    (22 pages, pdf 294kb)
  • Scale up Planning Guide for The Prevention of Mother-to-Child Transmission of HIV and Paediatric HIV Care, Treatment and Support
    2007, WHO
    Step 1: Identify a national focal point who will ensure the coordination of the process
    Step 2: Establish a national stakeholder coordinating or working committee
    Step 3: Conduct a rapid baseline assessment or programme review
    Step 4: Develop the national plan to scale care, treatment and support scale up plan
    Step 5: Implement the national the scale up plan including monitoring and evaluation
    (41 pages, pdf 534kb)