Practical guidance for scaling up health service innovations

1. Policy/Political/Legal/Institutional Scaling Up - also known as vertical scaling up, takes place when formal government decisions are made to adopt the innovation on a national or subnational level and it is institutionalised through national planning mechanisms, policy changes or legal action.

2. Strong Advocacy - essential in vertical scaling up to build legitimacy for the innovation and the need for change.

3. Legitimising Change - essential for getting policies approved, budgetary priorities adopted, and for developing the support needed for implementation of the innovation.

4. Spontaneous Diffusion - from individual to individual and from innovative programme settings to other environments.

5. Expansion or Replication - also known as horizontal scaling up, happens when innovations are replicated in different geographical sites or are extended to serve larger or new categories of populations.

6. Diversification - also called functional scaling up, consists of testing and adding interventions to an existing package.

How can we get the government to support and adopt this idea?

How can we convince others that this idea is important?

How can we make sure people see this change as necessary and good?

How can we make sure our idea spreads naturally to other places?

How can we copy and expand this idea to new areas?

What new things can we add to make this project even better?