|
Abstract BACKGROUND AND OBJECTIVES: Pilots to Regional Programs (PRP) is a broad-based initiative for bringing to scale a series of reproductive health (RH) interventions, first introduced almost seven years ago into Zambia’s Copperbelt Province. Launched in 2002, PRP aims to expand contraceptive choice and increase the availability of quality RH services in all eight of the Copperbelt’s rural and periurban districts. It also seeks to field-test a model for scaling up RH interventions originally implemented on a pilot basis. The model employs a three-phased process in which districts adhere to a common set of quality standards while maintaining the flexibility to decide, based on local needs and conditions, the most appropriate means to achieve these standards and the relative investment they intend to make in doing so. This presentation explores the programmatic challenges of moving from pilot study to broad-based initiative. It documents the history of the initiative, more specifically the circumstances leading to its development; its achievements; and the scaling up of activities. It also describes a conceptual framework to guide the scaling-up process, while at the same time addressing the potential trade-offs between increasing scale and the need to maintain quality, local values, local relevance, and sustainability. FINDINGS: This initiative has demonstrated that for scaling up services from a successful pilot project to a province-wide program to be successful, it is critical that a strategic process of planning and implementation is followed. The conceptual framework helped those responsible for the scaling-up process to think through and anticipate the inherent tensions between quality and quantity, expansion and local relevance, and higher costs and increased benefits. CONCLUSIONS: Scaling up successful pilot projects to sustainable programs remains a challenge. Strategic planning of the process is critical, and experiences gained from the PRP and other documented efforts can contribute to improving the effectiveness of strategic planning through sharing the lessons learned. This page updated |
