China: Quality of care reform is underway in the
Chinese family planning program which seeks to re-focus the program
on client
needs,
informed choice of contraceptives, and better quality services. The
reform began as a pilot project among six counties and has now
become
a
blueprint
for reorienting the national program. Many lessons are being learned
from scaling up sensitive but needed innovation in a difficult political
environment. Read more...
Ghana: The Community-Based
Health Planning and Services (CHPS) Initiative has
successfully replicated within the national health programme experimental
service delivery innovations
developed
and tested by the Navrongo Health Research Centre in northern Ghana.
Using locally available resources, the initiative has demonstrated
the feasibility of reorienting primary health care from clinics to
communities by mobilizing traditional social institutions to foster
volunteerism, community support, and decentralized planning. The
Expanding Community Healthcare Accessibility (ExCHANGE) Network aims
to extend Ghana’s successful community
health service program to other African countries. Using the CHPS
process, the ExCHANGE Network aims to achieve in five years what
Ghana is in the process of scaling up now. ExCHANGE is currently
comprised of health officials from Burkina Faso, Ethiopia, Ghana,
and Sierra Leone,
and
seeks to establish partnerships with key actors at all levels of
the system to improve the health of communities.
The
Fertility Awareness-based Methods (FAM) Project of the Georgetown
University Institute for Reproductive Health:
In October 2007, the Georgetown University Institute for Reproductive
Health (IRH) requested
the assistance of ExpandNet in strategic planning and research
on scaling up within the context of their USAID-funded
Fertility Awareness-based Methods project. The FAM project
seeks to scale up the provision and use of the Standard Days Method,
the Two-Day Method and the lactational amenorrhea method in six-ten
countries over five years. Thus far, ExpandNet members have collaborated
with IRH and country teams in Madagascar and Mali.
The Implementing Best Practices Initiative: Initiated
by the World Health Organization and USAID, the Implementing
Best Practices Initiative (IBP) focuses on developing
and supporting strategies that introduce, adapt and apply evidence-based
practices to improve access to and quality of reproductive health
care. ExpandNet joined the IBP Initiative as a member in mid-2007. A
Guide for Fostering Change to Scale Up Effective Health Services produced
by the IBP Consortium is currently being adapted to a the virtual
environment by the Leadership,
Management, and Sustainability (LMS) Project of
Management Sciences for Health (MSH). ExpandNet has been collaborating
with this initiative to create two modules of the program that
relate to scaling up and which are based on the ExpandNet nine
step process for developing a scaling up strategy.
The Reprolatina Project
in Latin America: The
Reprolatina Project seeks to expand service innovations
and participatory approaches pioneered
in connection with the Strategic Approach in Brazil to other municipalities
in that country and to other countries in Latin America including
Bolivia, Chile, and Paraguay. This project utilizes an innovative
participatory training and education program which
addresses the institutional capacity-building and technical competence
requirements for scaling up strategies in a highly decentralized
program environment.
It has also developed special approaches to reach adolescents
and men and has used interactive web-based technologies for
information
dissemination
and communicaion
among project partners.
The
Stronger Voices initiative: Led by UNFPA with participation
of WHO-RHR, ILO/STEP and UNICEF, The
Stronger Voices for Reproductive Health Project, worked
in six countries to develop, test and scale up innovative
models to
improve the quality of care in reproductive health service delivery.
ExpandNet worked with partners from Stronger Voices projects
in Kyrgyzstan and Peru to help develop country specific strategies
for scaling up. The Kyrgyzstan Stronger Voices project was focused
on improving quality of care and access to services through building
social support mechanisms into community structures, as well
as by
working with providers to increase technical competence. In Peru
the project sought to strengthen reproductive health client-provider
interactions; empowering women and adolescents; strengthening
NGO, government and UN partnerships; and increasing organizational
capacities
to provide quality services. ExpandNet worked with the two country
teams to institutionalize and further scale up the project innovations
with governments at various levels. ExpandNet also co-organized
a workshop at UNFPA headquarters, with country counterpart
participation, to help build capacity within UNFPA to focus
more systematically
on scaling
up. This
two
and half day meeting was attended by UNFPA Technical Support Division
staff, other UNFPA headquarters staff, and a number of country
representatives and their ministry counterparts. Countries represented
included Mongolia,
Malawi, Mauritania, Turkey, Thailand, Kyrgyzstan and Peru.
Viet Nam: In applying the Strategic Approach,
the Viet Namese government implemented interventions for
introducing
the
contraceptive
DMPA while improving quality of
care for all contraceptive methods in it's family planning
program. This initiative first developed a comprehensive set of materials
and tools to strengthen quality of care, which was tested
in demonstration sites prior to being used to develop broader capacity
for implementing reproductive choice within a centralized, bureaucratic
and demographically-focused programme environment.
World Health Organization Department of Child and Adolescent Health and Development, has drawn on the ExpandNet scaling-up framework and guidance documents to develop tools and processes for scaling up adolescent friendly health services. Their “systemic process” helps programmers identify areas of work at the national, district and health facility levels that will result in strengthened health service provision for adolescents. The team has assisted several countries to work on scaling up adolescent friendly services, in some cases applying the ExpandNet nine-step approach to strategy development. Read more….
Zambia: The Strategic Approach in Zambia has resulted
in a project which initially field-tested a package of activities
to support service delivery in three rural health districts of the
Copperbelt region. The project strengthened the delivery of existing
and under-utilized contraceptive methods, developed referral systems
for methods not available on–site, and applied innovative
approaches to provider training. These innovations are being scaled
up to the entire Copperbelt Region in an approach which promotes
a common
set of quality standards, while maintaining flexibility in the implementation
of activities based on local needs and conditions.
