ESSAYS ON RESEARCH -- SCALING UP GLOBAL HEALTH INTERVENTIONS

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• ESSAYS ON RESEARCH -- SCALING UP GLOBAL HEALTH INTERVENTIONS

Citation: Yamey G (2011) Scaling Up Global Health Interventions: A Proposed Framework for Success. PLoS Med 8(6): e1001049. doi:10.1371/journal.pmed.1001049

Published: June 28, 2011

Copyright: © 2011 Gavin Yamey. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Funding: No funding was received for this work.

Competing interests: GY leads the San Francisco “hub” of E2Pi (the Evidence-to-Policy initiative), which has received funding from the Bill & Melinda Gates Foundation, the Global Fund to Fight AIDS, Tuberculosis and Malaria, and the Clinton Health Access Initiative; all three organizations are major funders of global health scale-up programs. GY is a former senior editor at PLoS Medicine and continues to freelance for the journal (he played no role in any editorial decisions about this paper or in the peer review process).

Abbreviations: ART, antiretroviral therapy; DOTs, directly observed therapy short course; GHI, global health initiative; LMIC, low- and middle-income country; NGO, non-governmental organization

Provenance: Not commissioned; externally peer reviewed

Summary Points below;  full text is at http://www.ploscollections.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1001049

• The rise in international aid to fund large-scale global health programs over the last decade has catalyzed interest in improving the science of scale-up.
• This Essay draws upon key themes in the emerging science of large-scale change in global health to propose a framework for explaining successful scale-up.
• Success factors for scaling up were identified from interviews with implementation experts and from the published literature.
• These factors include the following: choosing a simple intervention widely agreed to be valuable, strong leadership and governance, active engagement of a range of implementers and of the target community, tailoring the scale-up approach to the local situation, and incorporating research into implementation.