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Scaling up in international health

What are the key issues

Bibliographic Data

ID11492329
AuthorsLindsay Mangham-Jefferies (0000-0002-7292-6342, London School of Hygiene & Tropical Medicine), L J Mangham, K Hanson (0000-0002-2551-5276, London School of Hygiene & Tropical Medicine)
Year2010
Volume25
Issue2
Pages85-96
Publication date2010-03-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueHealth Policy and Planning (JOURNAL)
Journal identifiersISSN: 0268-1080 • E-ISSN: 1460-2237
PublisherOxford University Press (PUBLISHER • GB)
DOI10.1093/heapol/czp066
PMID20071454
OpenAlexW2127305651
LanguageEN
Citations received65
References cited77

The term 'scaling up' is now widely used in the international health literature, though it lacks an agreed definition. We review what is meant by scaling up in the context of changes in international health and development over the last decade. We argue that the notion of scaling up is primarily used to describe the ambition or process of expanding the coverage of health interventions, though the term has also referred to increasing the financial, human and capital resources required to expand coverage. We discuss four pertinent issues in scaling up the coverage of health interventions: the costs of scaling up coverage; constraints to scaling up; equity and quality concerns; and key service delivery issues when scaling up. We then review recent progress in scaling up the coverage of health interventions. This includes a considerable increase in the volume of aid, accompanied by numerous new health initiatives and financing mechanisms. There have also been improvements in health outcomes and some examples of successful large-scale programmes. Finally, we reflect on the importance of obtaining a better understanding of how to deliver priority health interventions at scale, the current emphasis on health system strengthening and the challenges of sustaining scaling up in the prevailing global economic environment.

Business · Context (archaeology) · Economic growth · Economics · Equity (law) · Global health · Health care · Political science · Psychological intervention · Risk analysis (engineering) · Scale (ratio) · Scaling · Global Maternal and Child Health · Global Public Health Policies and Epidemiology · Healthcare Systems and Reforms · Medicine · Nursing · Health Policy

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Unique citing works65
Citations per year4,06
Citation span2010 - 2026 (17)
Citation velocitycurrent
Highly citedNo
Citation typesNeutral: 60
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