The pitfalls of scaling up evidence-based interventions in health
Datos Bibliográficos
| ID | 19529508 |
|---|---|
| Autores | Hervé Tchala Vignon Zomahoun (0000-0001-6328-5451, Université Laval), Ali Ben Charif (0000-0003-2893-2910, Université Laval), Adriana Freitas (0000-0002-4867-6347, Université Laval), Mirjam M Garvelink (0000-0001-5616-0597, Université Laval), Matthew Menear (0000-0002-0436-6574, Université Laval), Michèle Dugas (0000-0002-5112-6231, Université Laval), Rhéda Adekpedjou (0000-0003-2271-8059, Université Laval), France Légaré (0000-0002-2296-6696, Université Laval, autor de correspondencia) |
| Año | 2019 |
| Volumen | 12 |
| Número | 1 |
| Páginas | 1670449 |
| Fecha de publicación | 2019-01-01 |
| Peer Reviewed | Sí |
| Open Access | Sí |
| Tipo | ARTICLE |
| Revista | Global Health Action (JOURNAL) |
| Identificadores de la revista | ISSN: 1654-9716 • E-ISSN: 1654-9880 |
| Editorial | Informa UK Limited (PUBLISHER • GB) |
| DOI | 10.1080/16549716.2019.1670449 |
| PMID | 31575331 |
| OpenAlex | W2977879436 |
| Idioma | EN |
| Citas recibidas | 15 |
| Referencias citadas | 53 |
Policy-makers worldwide are increasingly interested in scaling up evidence-based interventions (EBIs) to larger populations, and implementation scientists are developing frameworks and methodologies for achieving this. But scaling-up does not always produce the desired results. Why not? We aimed to enhance awareness of the various pitfalls to be anticipated when planning scale-up. In lower- and middle-income countries (LMICs), the scale-up of health programs to prevent or respond to outbreaks of communicable diseases has been occurring for many decades. In high-income countries, there is new interest in the scaling up of interventions that address communicable and non-communicable diseases alike. We scanned the literature worldwide on problems encountered when implementing scale-up plans revealed a number of potential pitfalls that we discuss in this paper. We identified and discussed the following six major pitfalls of scaling-up EBIs: 1) the cost-effectiveness estimation pitfall, i.e. accurate cost-effectiveness estimates about real-world implementation are almost impossible, making predictions of economies of scale unreliable; 2) the health inequities pitfall, i.e. some people will necessarily be left out and therefore not benefit from the scaled-up EBIs; 3) the scaled-up harm pitfall, i.e. the harms as well as the benefits may be amplified by the scaling-up; 4) the ethical pitfall, i.e. informed consent may be a challenge on a grander scale; 5) the top-down pitfall, i.e. the needs, preferences and culture of end-users may be forgotten when scale-up is directed from above; and 6) the contextual pitfall, i.e. it may not be possible to adapt the EBIs to every context. If its pitfalls are addressed head on, scaling-up may be a powerful process for translating research data into practical improvements in healthcare in both LMICs and high-income countries, ensuring that more people benefit from EBIs
Business · Developing country · Economic growth · Economics · Geography · Global health · Harm · Health care · Political science · Psychological intervention · Public economics · Global Maternal and Child Health · Global Public Health Policies and Epidemiology · Health Policy Implementation Science · Medicine · Nursing
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| Obras citantes distintas | 15 |
|---|---|
| Citas por año | 3 |
| Intervalo de citas | 2021 - 2026 (6) |
| Velocidad de citación | current |
| Altamente citado | No |
| Tipos de cita | Neutras: 15 |