Presented by Bridgit Adamou at the International Conference on Family Planning in November 2013.

1. Monitoring the Scale-up of
Family Planning Practices and
Interventions
Bridgit Adamou
MEASURE Evaluation Population and
Reproductive Health (PRH) Project

2. Objectives
 Discuss the concept of scale-up and the importance
of monitoring and evaluating it
 Introduce the monitoring scale-up guide
 Present what information is included in the guide
 Highlight key components of the guide

3. What does “scale-up” mean?
ExpandNet’s definition: ““deliberate efforts to increase
the impact of health service innovations successfully
tested in pilot or experimental projects so as to benefit
more people and to foster policy and program
development on a lasting basis”
Scale-up entails the process of reaching more
people with a proven practice, more quickly, and more
effectively in a particular context.

4. Benefits of M&E of Scale-up
 Gain a better understanding of what it takes to scale up
the main elements of the practice
 Identify if there is essential information for continued
replication and sustainability
 Help to systematically plan for and manage scale-up
beyond routine implementation
 Determine if the core components of the practice are
being maintained
 Point to where more attention is needed
 Identify if the country ownership is being established

5. Guide to Monitoring Scale-up of
Health Practices and Interventions
Goal: To assist country
stakeholders with identifying
if scale-up is happening as
intended and if the scale-up
efforts can be sustained to
achieve the desired impact.

6. The guide is a practical “how to”
resource which includes:
 Rationale for monitoring scale-up
 Readiness assessment
 Ten considerations to monitoring scale-up
 “Defining the Innovation” guidance and worksheet
 Selected frameworks and approaches for scale-up
 Monitoring scale-up case studies
 GIS for monitoring expansion

7. Rationale
The two key elements for successful scale-up:
institutionalizing the practice and replicating it

8. Another way to look at scale-up…

9. Readiness Assessment
 Evidence exists that the scaled-up practice will likely
have a positive impact on health outcomes
 Experience from an evaluation of a local or comparable
pilot is available
 The scale-up adheres, to the extent possible, to existing
health system structures, processes, and practices
 The costs of scaling up have been identified and can be
monitored
 There is a strong level of interest/commitment
 There is a commitment to monitoring the scale-up
process

10. Ten Considerations to Monitoring
Scale-up
1. Define objectives and
scope of scale-up plan
2. Create a framework
3. Identify necessary
resources to implement
monitoring plan
4. Select indicators
5. Establish data sources
and reporting systems
6. Develop a data use and
dissemination plan
7. Collect data
8. Analyze data and
determine if scale-up is
progressing on track
9. Make program adjustments
based on findings and
recommendations
10. Continue the M&E process

11. Appendices
 IRH’s Defining the Innovation, with accompanying
worksheet
 Case Studies:
- PROGRESS Project: Monitoring the scale-up of
FP/CCC integration in Kenya
- FAM Project: Monitoring the scale-up of
standard days method in five countries
- Nutrition Communication Project: Monitoring vitamin
A promotion in Niger

12. Using GIS to Monitor Scale-up
GIS tools help to add an additional
component to data analysis — space.
The expansion aspect of scale-up is
inherently geographic in scope, and
therefore most any data that contains
a geographic component can be
imported into a GIS and mapped

13. Thank you
MEASURE Evaluation PRH is a MEASURE project funded by the United
States Agency for International Development (USAID) through cooperative
Agreement GHA-A-00-08-00003-00 and is implemented by the Carolina
Population Center at the University of North Carolina at Chapel Hill in
partnership with Futures Group International, Management Sciences for
Health, and Tulane University. Views expressed in this presentation do not
necessarily reflect the views of USAID or the U.S. Government.
MEASURE Evaluation PRH supports improvements in monitoring and
evaluation in population, health and nutrition worldwide.