The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #66376

Elvira Beracochea, MD MPH¹, Andrea May², Ian Sliney, MPH³, and Andy Tembon, MD PhD FRSH¹. (1) Regional and Country Programs, BASICS II, 1600 Wilson Blvd, Suite 300, Arlington, VA 22209, 703-312-6896, eberacochea@basics.org, (2) Regional and Country Programs, BASICS II Project, 1600 Wilson Blvd, Suite 300, Arlington, VA 22209, (3) Regional and Country Programs, Management Sciences for Health, 1600 Wilson Blvd, Suite 300, Arlington, VA 22209

For almost a decade, USAID, through the BASICS Projects, has been assisting many countries to develop the technical content and extend the geographic coverage of child survival interventions and programs. This has resulted in the achievement of significant population based impact in a number of country settings which is believed to have contributed to reduced child mortality.

Managing child survival programs at scale seeks to ensure efficiency and simplicity of program procedures while the scaling up strategy seeks to add more actors and resources at various levels. Management should also ensure consistency for sustaining quality results while being flexible in the implementation and expansion approach.

This session will review the conceptual framework and principles applied to guide the scaling up of these programs. It will also review case studies from Honduras, India, Senegal, Nigeria, and Democratic Republic of Congo that demonstrate how the framework and principles have worked in practice.

First, the session will review the definition of scale in the context of the project strategy and use this definition to review the public health impact objectives to be achieved. It will describe the types of programs developed and their implementation approaches, and the lessons that have been learned in managing the extension of their coverage to larger populations.

Second, the session will make recommendations based upon practical experience to address common barriers to working at scale and will suggest areas for further research to improve effectiveness, efficiency and quality while scaling up public health interventions.

Learning Objectives:

At the end of this session, participants will be able to:
• Define scale as the sum of managed technical growth and geographic expansion of BASICS programs (Taylor 2000), not simple addition or aggregation of districts or provinces. Be familiar with the principles to be employed to guide the scaling up of child health interventions and programs throughout various stages of program development.
• Discuss a variety of simple or integrated interventions and the management models used to achieve scale: partnerships, concerted strategies, collaboration in technical activities, resource and information sharing, sharing of results.
• Evaluate various phases to take child survival programs to scale: A. Initiation and Effectiveness; B. Growth: the top-down/bottom-up balance and the search for greater efficiency, depth and breadth; and C. Integration and Expansion
• Discuss common barriers to scaling up programs and interventions, and how they may be overcome.

Keywords: Access and Services, Management and Sustainability

Related Web page: basics.org

Presenting author's disclosure statement:
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: I am employed by the BASICS II Project