Table 1 Dimensions of scale-up and possible implementation research questions
Scaling-up dimensions informed by implementation research | Possible implementation research questions related to scaling-up |
|---|---|
Attributes of the innovation or service | Appropriateness: How appropriate and effective is the intervention? How well does it fit with the context and actors? Fidelity: Did the attributes of the innovation remain the same as planned throughout the implementation process? How were they adapted over time? |
Attributes of the target community and actors involved in scale-up | Acceptability: How acceptable is the intervention to key stakeholders? Intention to adopt: What are stakeholders intentions to adopt the intervention, and why is this the case? Coverage: Who is covered by the intervention? What are the attributes of those who are covered, and those who are not? |
Context | Feasibility: Is it possible to implement the intervention in this context, given the resources available, the health systems structures, etc.? |
Scaling-up strategy | Implementation cost: How much does it cost to deliver the intervention? Is this affordable? Could adaptations to design make the intervention more cost-effective? Sustainability: Is it possible to sustain the intervention once scaled up? What factors (intervention attributes, actors involved, context) contribute to or undermine sustainability? |