title: Scaling up high-impact interventions: how is it done?
abstract: Building upon the World Health Organization's ExpandNet framework, 12 key principles of scale-up have emerged from the implementation of maternal and newborn health interventions. These principles are illustrated by three case studies of scale up of high-impact interventions: the Helping Babies Breathe initiative; pre-service midwifery education in Afghanistan; and advanced distribution of misoprostol for self-administration at home births to prevent postpartum hemorrhage. Program planners who seek to scale a maternal and/or newborn health intervention must ensure that: the necessary evidence and mechanisms for local ownership for the intervention are well-established; the intervention is as simple and cost-effective as possible; and the implementers and beneficiaries of the intervention are working in tandem to build institutional capacity at all levels and in consideration of all perspectives.
authors.affiliation: Jhpiego, Baltimore, MD, USA. Electronic address: jeffrey.smith@jhpiego.org.
authors.forename: Jeffrey Michael
authors.initials: JM
authors.lastname: Smith
authors.affiliation: Save the Children/MCHIP, Washington, DC, USA.
authors.forename: Joseph
authors.initials: J
authors.lastname: de Graft-Johnson
authors.affiliation: International Confederation of Midwives, The Hague, Netherlands.
authors.forename: Pashtoon
authors.initials: P
authors.lastname: Zyaee
authors.affiliation: Jhpiego, Baltimore, MD, USA.
authors.forename: Jim
authors.initials: J
authors.lastname: Ricca
authors.affiliation: Independent consultant, San Diego, CA, USA.
authors.forename: Judith
authors.initials: J
authors.lastname: Fullerton
mesh_terms: D000346:Afghanistan; D005260:Female; D006700:Home Childbirth; D006801:Humans; D007231:Infant, Newborn; D008880:Midwifery / Q000193:education*; D016595:Misoprostol / Q000627:therapeutic use*; D010120:Oxytocics / Q000627:therapeutic use*; D006473:Postpartum Hemorrhage / Q000517:prevention & control*; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D012646:Self Administration; D014944:World Health Organization
chemical_list: D010120:Oxytocics; D016595:Misoprostol
keywords: Helping Babies Breathe; Maternal and newborn health; Midwifery; Misoprostol; Scale-up