Barker PM, Reid A, Schall MW. A framework for scaling up health interventions: Lessons from large-scale improvement initiatives in Africa. Implementation Science. 2016 Jan;11(1):12.
Scale-up of complex health interventions to large populations is not a straightforward task. This article details a sequence of four steps for taking a health intervention to full scale: 1. Set-up, 2. Develop the Scalable Unit, 3. Test of Scale-up, and 4. Go to Full Scale. Properties that facilitate adoption of the new ideas and the infrastructure required to support the scale-up are also described. Two case studies present national-scale initiatives in Ghana and South Africa that used early iterations of this framework to scale-up evidence-based interventions to improve maternal and child health.