The term scaling up is used today in a variety of ways. In some discussions it refers broadly to “doing more”. For example, in “scaling up treatment for HIV/AIDS”, we will be referring to deliberate efforts to increase the impact of successfully tested health innovations so as to benefit more people and to foster policy and programme development on a lasting basis. Innovation here refers to service components, other practices or products that are new or perceived as new. Typically, innovation consists of a “set of interventions” including not only a new technology, clinical practice, educational component or community initiative, but also the managerial processes necessary for successful implementation; while “Successfully tested” highlights that the interventions to be expanded are backed by locally generated evidence of programme effectiveness and feasibility obtained either through pilot, demonstration or experimental projects or through initial introduction in a limited number of local sites. Lastly, “Deliberate efforts” mark scaling up as a guided process, in contrast to the spontaneous diffusion of innovations.
But before we even talk about scaling up your project/initiative. The first question to ask is whether a project, program, or policy should be scaled up at all, and, if so, by how much, for how long, and in what direction or dimension. A decision to scale up project/initiative requires a reflection on its optimal size. Should the program operate on a national, provincial, or only local level? Diseconomies of scale, quality/scale trade-offs, and institutional/organizational constraints might limit the scaling-up path.
Therefore, scaling up does not necessarily mean national coverage. On the other hand, scaling up also may entail going beyond national borders. To be very effective in the long term, some projects/initiatives need to be expanded to a regional scale. The answers to the questions of what to scale up, how far, how long, and in what dimension cannot be set in stone. It is important to be aware of the questions and address them systematically and continuously when proceeding with the implementation. At the same time, it is important to consider how to scale up. Scaling up takes time, often 10 to 15 years, or more. This long time horizon poses great challenges: donors shift priorities, governments change, NGO funding is driven by fashion, and agency managers and staff move in and out. The long time horizon requires that scaling up be perceived as a systemic effort, not a short-term fad. Experiences with successful scaling-up programs have shown the importance of long-term commitment on the part of institutions, donors, and individuals.
External partners need to stay the course. At the same time, programs have to be designed in such a way that they survive changes in government. This requires a systematic strategy for how to scale up. At a minimum, it requires a basic set of institutional values and incentives to ensure that key actors are continuously searching for ways to build on successful interventions, which, in turn, ensures that they are replicated, expanded, transferred, and adapted in other settings. There are three building blocks for designing scaling-up strategies and instilling them with the basic values and incentives of vision, drivers, and space to grow.
Three building blocks for designing scaling up strategies are discussed below-
Ideally, a vision for scaling up should be developed as the first phase of a program, frequently called a pilot, is being put into place. Pilots should be designed in such a way that they can be scaled up if successful. However, such a vision for scaling up rarely exists when programs are first designed and initiated. Far too frequently, donors and governments design operations as onetime interventions. Projects that are “expensive boutiques” with high unit costs and high management and human skill intensities may be successful on a limited scale, but they generally cannot be and are not being replicated on a larger scale. Because not every project or program could or should be scaled up, the question of whether scaling up is appropriate should be explicitly factored into the decision of whether and how to implement the intervention in the first place. If program designers believe that their interventions eventually should be taken to a larger scale, then they need a vision and a strategy for how to proceed beyond the first phase or pilot project.
Scaling up is a dynamic process requiring a force or driver to propel it forward. First, there has to be an idea, an innovation that meets a need or creates a demand among people. Second, there has to be a leader or champion. All successful programs that have expanded from small beginnings have benefited from charismatic leaders who are endowed with a vision, are persistent in their efforts, are often well connected to major stakeholders and constituencies, and have the ability to command respect and guide people. Similarly, the notion that an NGO can combat global corruption required the inspired leadership of Peter Eigen, which led to the establishment of Transparency International. Finally, external catalysts can serve as drivers of change and scaling up.
Space to Grow-
Ideas, champions, and external catalysts are not enough, however. For interventions to be scaled up, they need space in which to grow. Sometimes, such space already exists, but more often than not it has to be created. A number of interrelated spatial dimensions must be available if interventions are to be replicated and scaled up successfully. These spaces include fiscal, political, economic, capacity, cultural, partnership and learning spaces.
Unit 4 Credits:
Nine steps for developing a scaling up strategy- WHO 2020 FOCUS BRIEF on the World’s Poor and Hungry People- Brookings institution.