Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #116139

Ruth Simmons, PhD¹, Peter Fajans, MD, MPH², and Laura J. Ghiron, MPH¹. (1) Department of Health Behavior and Health Education, University of Michigan School of Public Health, 1420 Washington Heights - 5th floor, Ann Arbor, MI 48109-2029, 734-936-0926, rsimmons@umich.edu, (2) World Health Organization, Department of Reproductive Health and Research, Geneva 27, CH-1211, Switzerland

Recent reproductive health initiatives in Asia, Africa and Latin America have sought to address the need for expanding and sustaining the impact of small-scale successful projects to benefit more people and advance policy and program development. This paper presents key lessons from scaling-up projects in Brazil and Vietnam which are focused on improving the quality of care and equitable access to family planning and related reproductive health services within the public sector. Projects grew out of the World Health Organization-sponsored Strategic Approach for Strengthening Reproductive Health Policies and Programs, a methodology which explicitly links scaling-up to assessment of needs and the testing of service innovations. Experience from these case studies will be analyzed using a conceptual framework that builds on theories of the diffusion of innovation, knowledge transfer, open-systems and research utilization. Lessons highlighted relate to: 1) the need to consider scaling-up at the beginning and throughout rather than at the conclusion of pilot projects; 2) the critical trade-offs confronting decision-makers between the amount of change implied in the health service innovations, the pace of change and the resources available for scaling-up; 3) the influence of health sector reform and decentralization on the success of taking health service innovations to scale; 4) the importance of a strong resource team with close ties to local communities; and 5) the need to focus on monitoring and evaluating the process and outcomes of scaling up so that the determinants of success can be better understood.

Learning Objectives: After listening to this presentation, participants will be able to

• assess the value of the Strategic Approach as an evidence-based policy and program development tool focused on scaling-up,
• recognize the opportunities and constraints for scaling-up resulting from different health sector environments, and
• understand the role of policy and institutional change in scaling-up.

Keywords: Policy/Policy Development, International Reproductive Health

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

Recorded presentation