The role of intervention complexity for the feasibility of scaling-up health interventions in low and middle-income countries

2004 ◽  
Author(s):  
C.A. Gericke ◽  
M.K. Ranson ◽  
C. Kurowski ◽  
A. Mills
Keyword(s):  
Scaling Up ◽  
Health Interventions ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

scholarly journals Factors influencing the scale-up of public health interventions in low- and middle-income countries: a qualitative systematic literature review

2019 ◽  
Vol 35 (2) ◽  
pp. 219-234 ◽  
Author(s):  
Susan E Bulthuis ◽  
Maryse C Kok ◽  
Joanna Raven ◽  
Marjolein A Dieleman
Keyword(s):  
Public Health ◽  
Scale Up ◽  
Scaling Up ◽  
Health Interventions ◽  
Public Health Interventions ◽  
Middle Income ◽  
Middle Income Countries ◽  
Factors Influencing ◽  
Low And Middle Income ◽  
The Way

Abstract To achieve universal health coverage, the scale-up of high impact public health interventions is essential. However, scale-up is challenging and often not successful. Therefore, a systematic review was conducted to provide insights into the factors influencing the scale-up of public health interventions in low- and middle-income countries (LMICs). Two databases were searched for studies with a qualitative research component. The GRADE-CERQual approach was applied to assess the confidence in the evidence for each key review finding. A multi-level perspective on transition was applied to ensure a focus on vertical scale-up for sustainability. According to this theory, changes in the way of organizing (structure), doing (practice) and thinking (culture) need to take place to ensure the scale-up of an intervention. Among the most prominent factors influencing scale-up through changes in structure was the availability of financial, human and material resources. Inadequate supply chains were often barriers to scale-up. Advocacy activities positively influenced scale-up, and changes in the policy environment hindered or facilitated scale-up. The most outstanding factors influencing scale-up through changes in practice were the availability of a strategic plan for scale-up and the way in which training and supervision was conducted. Furthermore, collaborations such as community participation and partnerships facilitated scale-up, as well as the availability of research and monitoring and evaluation data. Factors influencing scale-up through a change in culture were less prominent in the literature. While some studies articulated the acceptability of the intervention in a given sociocultural environment, more emphasis was placed on the importance of stakeholders feeling a need for a specific intervention to facilitate its scale-up. All identified factors should be taken into account when scaling up public health interventions in LMICs. The different factors are strongly interlinked, and most of them are related to one crucial first step: the development of a scale-up strategy before scaling up.

scholarly journals Designing the next generation of implementation research training for learners in low- and middle-income countries

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Michael J. Penkunas ◽  
Shiau Yun Chong ◽  
Emma L. M. Rhule ◽  
Evangelia Berdou ◽  
Pascale Allotey
Keyword(s):  
Implementation Research ◽  
Research Training ◽  
Training Model ◽  
Learning By Doing ◽  
Health Interventions ◽  
System Level ◽  
High Quality Research ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

AbstractEfficacious health interventions tested through controlled trials often fail to show desired impacts when implemented at scale. These challenges can be particularly pervasive in low- and middle-income settings where health systems often lack the capacity and mechanisms required for high-quality research and evidence translation. Implementation research is a powerful tool for identifying and addressing the bottlenecks impeding the success of proven health interventions. Implementation research training initiatives, although growing in number, remain out of reach for many investigators in low- and middle-income settings, who possess the knowledge required to contextualize challenges and potential solutions in light of interacting community- and system-level features. We propose a realigned implementation research training model that centers on team-based learning, tailored didactic opportunities, learning-by-doing, and mentorship.

Gender counts: A systematic review of evaluations of gender-integrated health interventions in low- and middle-income countries

2016 ◽  
Vol 12 (11) ◽  
pp. 1335-1350 ◽  
Author(s):  
Brittany Schriver ◽  
Mahua Mandal ◽  
Arundati Muralidharan ◽  
Anthony Nwosu ◽  
Radhika Dayal ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Interventions ◽  
Middle Income ◽  
Middle Income Countries ◽  
Integrated Health ◽  
Low And Middle Income
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