title: Scaling up community mobilisation through women's groups for maternal and neonatal health: experiences from rural Bangladesh.
abstract: BACKGROUND
  Program coverage is likely to be an important determinant of the effectiveness of community interventions to reduce neonatal mortality. Rigorous examination and documentation of methods to scale-up interventions and measure coverage are scarce, however. To address this knowledge gap, this paper describes the process and measurement of scaling-up coverage of a community mobilisation intervention for maternal, child and neonatal health in rural Bangladesh and critiques this real-life experience in relation to available literature on scaling-up.
  
  
  METHODS
  Scale-up activities took place in nine unions in rural Bangladesh. Recruitment and training of those who deliver the intervention, communication and engagement with the community and other stakeholders and active dissemination of intervention activities are described. Process evaluation and population survey data are presented and used to measure coverage and the success of scale-up.
  
  
  RESULTS
  The intervention was scaled-up from 162 women's groups to 810, representing a five-fold increase in population coverage. The proportion of women of reproductive age and pregnant women who were engaged in the intervention increased from 9% and 3%, respectively, to 23% and 29%.
  
  
  CONCLUSIONS
  Examination and documentation of how scaling-up was successfully initiated, led, managed and monitored in rural Bangladesh provide a deeper knowledge base and valuable lessons.Strong operational capabilities and institutional knowledge of the implementing organisation were critical to the success of scale-up. It was possible to increase community engagement with the intervention without financial incentives and without an increase in managerial staff. Monitoring and feedback systems that allow for periodic programme corrections and continued innovation are central to successful scale-up and require programmatic and operational flexibility.
authors.affiliation: University College, London, UK. e.fottrell@ich.ucl.ac.uk
authors.forename: Tasmin
authors.initials: T
authors.lastname: Nahar
authors.forename: Kishwar
authors.initials: K
authors.lastname: Azad
authors.forename: Bedowra Haq
authors.initials: BH
authors.lastname: Aumon
authors.forename: Layla
authors.initials: L
authors.lastname: Younes
authors.forename: Sanjit
authors.initials: S
authors.lastname: Shaha
authors.forename: Abdul
authors.initials: A
authors.lastname: Kuddus
authors.forename: Audrey
authors.initials: A
authors.lastname: Prost
authors.forename: Tanja A J
authors.initials: TA
authors.lastname: Houweling
authors.forename: Anthony
authors.initials: A
authors.lastname: Costello
authors.forename: Edward
authors.initials: E
authors.lastname: Fottrell
mesh_terms: D000328:Adult; D001459:Bangladesh / Q000453:epidemiology; D003153:Community Health Services / Q000458:organization & administration*; D019058:Community Networks / Q000458:organization & administration*; D036861:Delivery, Obstetric / Q000193:education; D003906:Developing Countries; D005260:Female; D006801:Humans; D007224:Infant Care / Q000458:organization & administration*; D007229:Infant Welfare / Q000706:statistics & numerical data*; D007231:Infant, Newborn; D007398:Interpersonal Relations; D010353:Patient Education as Topic; D011181:Postnatal Care / Q000379:methods*; D011247:Pregnancy; D012424:Rural Population / Q000706:statistics & numerical data*; D055815:Young Adult