'Scaling-up is a craft not a science': Catalysing scale-up of health innovations in Ethiopia, India and Nigeria.

摘要: Donors and other development partners commonly introduce innovative practices technologies to improve health in low middle income countries. Yet many innovations that are effective improving survival slow be translated into policy implemented at scale. Understanding the factors influencing scale-up is important. We conducted a qualitative study involving 150 semi-structured interviews with government, partners, civil society organisations externally funded implementers, professional associations academic institutions 2012/13 explore of interventions targeting mothers newborns Ethiopia, Indian state Uttar Pradesh six states northeast Nigeria, which settings high burdens maternal neonatal mortality. Interviews were analysed using common analytic framework developed for cross-country comparison themes coded Nvivo. found programme implementers across three require multiple steps catalyse scale-up. Advocating government adopt finance requires: designing scalable innovations; embedding design allocating time resources; building implementer capacity scale-up; adopting approaches advocacy; presenting strong evidence support decision making; design; invoking champions networks; strengthening harmonisation among external programmes; aligning systems priorities. Other include: supporting develop policies programmes staff; promoting community uptake by media, leaders, mobilisation teams role models. conclude has no magic bullet solution - must embrace activities, substantial from donors governments doing so.