Scaling-Up Cancer Control Innovations

2018 ◽  
Author(s):  
Nancy C. Edwards ◽  
Barbara L. Riley ◽  
Cameron D. Willis
Keyword(s):  
Evaluation System ◽  
Scale Up ◽  
Cancer Control ◽  
Monitoring And Evaluation ◽  
Scaling Up ◽  
Political Support ◽  
Human Papillomavirus Vaccination ◽  
Media Campaigns ◽  
Five Dimensions ◽  
Key Stakeholders

This chapter examines characteristics of and approaches to scaling-up innovations and programs, with illustrations from the field of cancer control. It summarizes definitions of scale-up, emphasizing the introduction of innovations with demonstrated effectiveness and the aims of scale-up: improving coverage and equitable access to the innovation(s) and its intended benefits. The chapter proposes a typology to help guide scaling-up activities. The typology includes five dimensions: the object of scale-up, how this object may be adapted, horizontal and vertical directions for scale-up, linear and nonlinear pathways for scale-up, and factors influencing scale-up. Featuring examples of tobacco control and human papillomavirus vaccination, the typology is applied and key scaling-up actions are described, including media campaigns, engaging key stakeholders, mobilizing political support, and investing in a monitoring and evaluation system. Systemic challenges to scale-up are discussed. Future priorities for research on scaling up cancer control initiatives are proposed.

scholarly journals Institutional Barriers to Climate Change Adaptation in Burkina Faso: How could We Go around Them?

2020 ◽  
Vol 13 (5) ◽  
pp. 67
Author(s):  
Fiacre Basson ◽  
Djibril S. Dayamba ◽  
Joel Korahire ◽  
Jean M. Dipama ◽  
Francois Zougmore ◽  
...  
Keyword(s):  
Climate Change ◽  
Burkina Faso ◽  
Climate Change Adaptation ◽  
Focal Point ◽  
Monitoring And Evaluation ◽  
Political Support ◽  
Structured Interviews ◽  
Institutional Barriers ◽  
Strategic Objectives ◽  
Key Stakeholders

Despite the existence of a National Adaptation Plan to climate change (NAP) in Burkina Faso, operationalizing adaptation still face a number of challenges. The current study focused on identifying institutional barriers to the strategic objectives of climate change adaptation (CCA) using a literature review and semi-structured interviews conducted with key stakeholders / resource persons involved in the implementation of the NAP. The results revealed a weak collaboration between the NAP steering institution and the ministerial departments covered by the NAP. This situation, first, hampers the implementation of adaptation actions and secondly, the monitoring reporting and verification of adaptation initiatives. Further, the analysis revealed that lack of financial resources poses constraints to many actions that were to be taken by the steering institution and therefore creates poor ownership of the NAP by the main stakeholders that should be actively involved in the NAP process. To cope with the various constraints, it is necessary to have strong political support in many aspects. For instance, it was judged that institutionalizing the role of climate change (CC) focal point within the ministries and embedding NAP monitoring and evaluation (M&E) objectives and indicators with existing functional M&E systems in the sectorial ministries will ease CCA actions integration in operational plans, their implementation and documentation. Moreover, it is relevant to have a continuous capacity building plan to keep stakeholders updated on climate change issues as this will support them in their mandate of mainstreaming CC into ministerial operational plans and lead to optimal CCA implementation and monitoring.

scholarly journals The six-sphere framework: A practical tool for assessing monitoring and evaluation systems

2017 ◽  
Vol 5 (1) ◽  
Author(s):  
Kieron D. Crawley
Keyword(s):  
Evaluation System ◽  
Supply And Demand ◽  
Monitoring And Evaluation ◽  
Evaluation Systems ◽  
Key Stakeholders ◽  
Demand Models ◽  
Graphic Device ◽  
Practical Tool ◽  
Nuanced Understanding ◽  
Technical Capacity

Background: Successful evaluation capacity development (ECD) at regional, national and institutional levels has been built on a sound understanding of the opportunities and constraints in establishing and sustaining a monitoring and evaluation system. Diagnostics are one of the tools that ECD agents can use to better understand the nature of the ECD environment. Conventional diagnostics have typically focused on issues related to technical capacity and the ‘bridging of the gap’ between evaluation supply and demand. In so doing, they risk overlooking the more subtle organisational and environmental factors that lie outside the conventional diagnostic lens.Method: As a result of programming and dialogue carried out by the Centre for Learning on Evaluation and Results Anglophone Africa engaging with government planners, evaluators, civil society groups and voluntary organisations, the author has developed a modified diagnostic tool that extends the scope of conventional analysis.Results: This article outlines the six-sphere framework that can be used to extend the scope of such diagnostics to include considerations of the political environment, trust and collaboration between key stakeholders and the principles and values that underpin the whole system. The framework employs a graphic device that allows the capture and organisation of structural knowledge relating to the ECD environment.Conclusion: The article describes the framework in relation to other organisational development tools and gives some examples of how it can be used to make sense of the ECD environment. It highlights the potential of the framework to contribute to a more nuanced understanding of the ECD environment using a structured diagnostic approach and to move beyond conventional supply and demand models.

scholarly journals Multiple pathways to scaling up and sustainability: An exploration of digital health solutions in South Africa

2020 ◽  
Author(s):  
Alison Swartz ◽  
Amnesty E LeFevre ◽  
Shehani Perera ◽  
Mary V. Kinney ◽  
Asha S George
Keyword(s):  
South Africa ◽  
Digital Health ◽  
National Level ◽  
Scale Up ◽  
Monitoring And Evaluation ◽  
Scaling Up ◽  
Value Proposition ◽  
Problem Identification ◽  
Human Resource Capacity ◽  
Organisational Context

Abstract Background With an aim to support further understanding of scaling up and sustaining digital health, we explore digital health solutions that have or are anticipated to reach national scale in South Africa: the Perinatal Problem Identification Programme and Child Healthcare Problem Identification Programme (mortality audit reporting and visualisation tools), MomConnect (a direct to consumer maternal messaging and feedback service) and CommCare (a community health worker data capture and decision-support application). Results A framework integrating complexity and scaling up processes was used to conceptually orient the study. Findings are presented by case through four domains: value proposition, actors, technology and organisational context. The scale and use of PPIP and Child PIP were driven by ‘champions’; clinicians who developed technically simple tools to digitise clinical audit data. Top-down political will at the national level drove the scaling of MomConnect, supported by ongoing financial and technical support from donors and technical partners. Donor preferences played a significant role in the selection of CommCare as the platform to digitise CHW service information, with a focus on HIV and TB. A key driver of scale across cases is leadership that recognises and advocates for the value of the digital health solution. The technology need not be complex but must navigate the complexity of operating within an overburdened and fragmented South African health system, where adequate and sustained investment from donors and government overall, and in particular in its human resource capacity and in robust monitoring and evaluation continue to threaten the sustainability of digital health solutions. Conclusions There is no single pathway to achieving scale up or sustainability, and there will be successes and challenges regardless of the configuration of the domains of value proposition, technology, actors and organisational context. While scaling and sustaining digital solutions has its technological challenges, perhaps more complex are the idiosyncratic factors and nature of the relationships between actors involved. Scaling up and sustaining digital solutions need to account for the interplay of the various technical and social dimensions involved in supporting digital solutions to succeed, particularly in health systems that are themselves social and political dynamic systems.

scholarly journals Scaling-up an evidence-based intervention for osteoarthritis in real world settings: A pragmatic evaluation using the RE-AIM framework

2020 ◽  
Author(s):  
Andrew Walker ◽  
Annette Boaz ◽  
Amber Gibney ◽  
Zoe Zambelli ◽  
Michael V Hurley
Keyword(s):  
Real World ◽  
Scale Up ◽  
Hip Osteoarthritis ◽  
Monitoring And Evaluation ◽  
Scaling Up ◽  
Health Science ◽  
Evidence Based ◽  
Academic Health ◽  
National Network ◽  
Gradual Process

Abstract Background : Scaling-up and sustaining effective healthcare interventions is essential for improving healthcare; however, relatively little is known about these processes. In addition to quantitative experimental designs we need approaches that use embedded, observational studies on practice-led, naturally-occurring scale-up processes. There are also tensions between having adequately rigorous systems to monitor and evaluate scale-up well that are proportionate and pragmatic in practice. The study investigated the scale-up of an evidence-based complex intervention for knee and hip osteoarthritis (ESCAPE-pain) within ‘real-world’ settings by England’s 15 Academic Health Science Networks (AHSNs). Methods : A pragmatic evaluation of the scale-up of ESCAPE-pain using the RE-AIM framework to measure reach, effectiveness, adoption, implementation and maintenance. The evaluation used routine monitoring data collected from April 2014 to December 2019 as part of a national scale-up programme. Results : Between 2014-2018 ESCAPE-pain was adopted by over 110 clinical and non-clinical sites reaching over 9,000 people with osteoarthritis. The programme showed sustained clinical effectiveness (pain, function and quality of life) and high levels of adherence (78.5% completing 75% of the programme) within a range of real world settings. 770 people (physiotherapists and exercise professionals) have been trained to deliver ESCAPE-pain and 84.1% of sites have continued to deliver the programme post-implementation. Conclusions : ESCAPE-pain successfully moved from being an efficacious “research intervention” into an effective intervention within ‘real world’ clinical and non-clinical community settings. However, scale-up has been a gradual process requiring on-going, dedicated resources over 5 years by a national network of Academic Health Science Networks (AHSNs). Whilst the collection of monitoring and evaluation data is critical in understanding implementation and scale-up, there remain significant challenges in developing systems sufficiently rigorous, proportionate and locally acceptable.

scholarly journals Scaling-up an evidence-based intervention for osteoarthritis in real world settings: A pragmatic evaluation using the RE-AIM framework

2019 ◽  
Author(s):  
Andrew Walker ◽  
Annette Boaz ◽  
Amber Gibney ◽  
Zoe Zambelli ◽  
Michael V Hurley
Keyword(s):  
Real World ◽  
Scale Up ◽  
Hip Osteoarthritis ◽  
Monitoring And Evaluation ◽  
Scaling Up ◽  
Health Science ◽  
Evidence Based ◽  
Academic Health ◽  
National Network ◽  
Gradual Process

Abstract Background: Scaling-up and sustaining effective healthcare interventions is essential for improving healthcare; however, relatively little is known about these processes. In addition to quantitative experimental designs we need approaches that use embedded, observational studies on practice-led, naturally-occurring scale-up processes. There are also tensions between having adequately rigorous systems to monitor and evaluate scale-up well that are proportionate and pragmatic in practice. The study investigated the scale-up of an evidence-based complex intervention for knee and hip osteoarthritis (ESCAPE-pain) within ‘real-world’ settings by England’s 15 Academic Health Science Networks (AHSNs).Methods: A pragmatic evaluation of the scale-up of ESCAPE-pain using the RE-AIM framework to measure reach, effectiveness, adoption, implementation and maintenance. The evaluation used routine monitoring data collected from April 2014 to December 2019 as part of a national scale-up programme.Results: Between 2014-2018 ESCAPE-pain was adopted by over 110 clinical and non-clinical sites reaching over 9,000 people with osteoarthritis. The programme showed sustained clinical effectiveness (pain, function and quality of life) and high levels of adherence (78.5% completing 75% of the programme) within a range of real world settings. 770 people (physiotherapists and exercise professionals) have been trained to deliver ESCAPE-pain and 84.1% of sites have continued to deliver the programme post-implementation.Conclusions: ESCAPE-pain successfully moved from being an efficacious “research intervention” into an effective intervention within ‘real world’ clinical and non-clinical community settings. However, scale-up has been a gradual process requiring on-going, dedicated resources over 5 years by a national network of Academic Health Science Networks (AHSNs). Whilst the collection of monitoring and evaluation data is critical in understanding implementation and scale-up, there remain significant challenges in developing systems sufficiently rigorous, proportionate and locally acceptable.

scholarly journals Local food policies – their constraints and drivers: Insights from Portuguese Urban Agriculture initiatives

2020 ◽  
Vol 28 (3) ◽  
pp. 223-235
Author(s):  
Cecília Delgado
Keyword(s):  
Urban Agriculture ◽  
Food Systems ◽  
Local Food ◽  
Scale Up ◽  
Scaling Up ◽  
Political Support ◽  
Political Commitment ◽  
Raising Awareness ◽  
Food Policies

AbstractTwo interconnected questions are addressed in this paper: (i) why urban agriculture (UA) and food-related initiatives take usually years to materialise in Portugal; and (ii) why resilient initiatives do not scale up and shift from practices to local food policies. We argue that existing initiatives are viewed as single events and therefore garner quite limited long-term political commitment and support. Based on interviews with food champions and a literature review, four Portuguese UA initiatives are analysed and these highlight the constraints that hinder their scaling-up. We conclude that drivers to lead to scaling-up are a combination of factors, with an enabling environment the most relevant one. On the other hand, constraints are related to limited democratic governance and poor policies, insufficient funding and weak participatory processes. Such findings are quite in line with existing literature. The limited integration of Portugal within the international UA and food debates might partially explain why UA is still struggling to find its proper place in Portuguese cities and their peripheries. Raising awareness among decision makers is critical to scaling-up UA initiatives and turning them an integral component of local food systems. A national observatory able to gather relevant data and produce knowledge, assess and monitor on-going initiatives may be the key step to gather different stakeholders together, that can then better advocate and then lead to higher political support, not only in Portugal but in any country where UA and food issues are emerging.

scholarly journals Scaling early child development: what are the barriers and enablers?

2019 ◽  
Vol 104 (Suppl 1) ◽  
pp. S43-S50 ◽  
Author(s):  
Vanessa Cavallera ◽  
Mark Tomlinson ◽  
James Radner ◽  
Bronwynè Coetzee ◽  
Bernadette Daelmans ◽  
...  
Keyword(s):  
Early Childhood Development ◽  
Scale Up ◽  
Monitoring And Evaluation ◽  
Scaling Up ◽  
Global Strategy ◽  
Childhood Development ◽  
Semistructured Interview ◽  
Snowball Sampling ◽  
Strategic Choices ◽  
Framework Analysis

The Sustainable Development Goals, Global Strategy for Women’s, Children’s and Adolescents’ Health (2016–2030) and Nurturing Care Framework all include targets to ensure children thrive. However, many projects to support early childhood development (ECD) do not ‘scale well’ and leave large numbers of children unreached. This paper is the fifth in a series examining effective scaling of ECD programmes. This qualitative study explored experiences of scaling-up among purposively recruited implementers of ECD projects in low- and middle-income countries. Participants were sampled, by means of snowball sampling, from existing networks notably through Saving Brains®, Grand Challenges Canada®. Findings of a recent literature review on scaling-up frameworks, by the WHO, informed the development of a semistructured interview schedule. All interviews were conducted in English, via Skype, audio recorded and transcribed verbatim. Interviews were analysed using framework analysis. Framework analysis identified six major themes based on a standard programme cycle: planning and strategic choices, project design, human resources, financing and resource mobilisation, monitoring and evaluation, and leadership and partnerships. Key informants also identified an overarching theme regarding what scaling-up means. Stakeholders have not found existing literature and available frameworks helpful in guiding them to successful scale-up. Our research suggests that rather than proposing yet more theoretical guidelines or frameworks, it would be better to support stakeholders in developing organisational leadership capacity and partnership strategies to enable them to effectively apply a practical programme cycle or systematic process in their own contexts.

Educate! Developing a Theory of Change for “Changemakers”

2018 ◽  
Author(s):  
Mary Kay Gugerty ◽  
Dean Karlan
Keyword(s):  
Change Process ◽  
Evaluation System ◽  
Program Design ◽  
Field Research ◽  
Monitoring And Evaluation ◽  
Theory Of Change ◽  
Youth Empowerment ◽  
Evaluation Plan ◽  
Final Theory

A theory of change can build consensus on a program’s vision and guide the development of a right-fit monitoring and evaluation system. This case examines how the Uganda-based youth empowerment NGO Educate! used the theory of change process to clearly define its intended impact and decide how to measure it. After analyzing the process Educate! used to develop its theory of change, readers will be able to discuss the value of gathering internal perspectives and conducting field research to develop a theory of change. Readers will also assess how successive iterations of the theory of change provide clarity on program design and objectives and determine whether the final theory of change is sufficient to design a monitoring and evaluation plan that adheres to CART principles.

scholarly journals Strategies for involving patients and the public in scaling-up initiatives in health and social services: protocol for a scoping review and Delphi survey

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Ali Ben Charif ◽  
◽  
Karine V. Plourde ◽  
Sabrina Guay-Bélanger ◽  
Hervé Tchala Vignon Zomahoun ◽  
...  
Keyword(s):  
Social Services ◽  
Scoping Review ◽  
Delphi Study ◽  
Public Involvement ◽  
Scale Up ◽  
Scaling Up ◽  
Delphi Survey ◽  
The Public ◽  
Health And Social Services ◽  
Scoping Reviews

Abstract Background The scale-up of evidence-based innovations is required to reduce waste and inequities in health and social services (HSS). However, it often tends to be a top-down process initiated by policy makers, and the values of the intended beneficiaries are forgotten. Involving multiple stakeholders including patients and the public in the scaling-up process is thus essential but highly complex. We propose to identify relevant strategies for meaningfully and equitably involving patients and the public in the science and practice of scaling up in HSS. Methods We will adapt our overall method from the RAND/UCLA Appropriateness Method. Following this, we will perform a two-prong study design (knowledge synthesis and Delphi study) grounded in an integrated knowledge translation approach. This approach involves extensive participation of a network of stakeholders interested in patient and public involvement (PPI) in scaling up and a multidisciplinary steering committee. We will conduct a systematic scoping review following the methodology recommended in the Joanna Briggs Institute Reviewers Manual. We will use the following eligibility criteria: (1) participants—any stakeholder involved in creating or testing a strategy for PPI; (2) intervention—any PPI strategy proposed for scaling-up initiatives; (3) comparator—no restriction; (4) outcomes: any process or outcome metrics related to PPI; and (5) setting—HSS. We will search electronic databases (e.g., Medline, Web of Science, Sociological Abstract) from inception onwards, hand search relevant websites, screen the reference lists of included records, and consult experts in the field. Two reviewers will independently select and extract eligible studies. We will summarize data quantitatively and qualitatively and report results using the PRISMA extension for Scoping Reviews (PRISMA-ScR) checklist. We will conduct an online Delphi survey to achieve consensus on the relevant strategies for PPI in scaling-up initiatives in HSS. Participants will include stakeholders from low-, middle-, and high-income countries. We anticipate that three rounds will allow an acceptable degree of agreement on research priorities. Discussion Our findings will advance understanding of how to meaningfully and equitably involve patients and the public in scaling-up initiatives for sustainable HSS. Systematic review registration We registered this protocol with the Open Science Framework on August 19, 2020 (https://osf.io/zqpx7/).

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