Background
At specific times and situations, a country needs to prioritize which investments to make and in which quantities to ensure it is contributing to health and wellbeing. At present, the priority-setting process is based on one or more of three attributes of an intervention when compared with alternatives.- EFFECTIVENESS – the intervention is best able to achieve the desired result;
- EQUITY – the intervention better at targeting vulnerable beneficiaries or
- EFFICIENCY – the intervention represents better value for money.
Scalability is interpreted as the ability of a health intervention shown to be efficacious on a small scale or under controlled conditions to be expanded under real-world conditions to reach a greater proportion of the eligible population, while retaining effectiveness, efficiency, and equity. By adapting scalability within the priority setting attributes, countries will have information on interventions that will increase the impact, adoption and reach to improve health service utilization by targeted beneficiaries.
Methodology
To initiate the process, the WHO/AFRO first identified a multidisciplinary team to review the evidence from published literature and systematic reviews to identify potential attributes of an AFRO Scalability assessment framework (Version 0). The draft was reviewed meticulously, and content refined (components and attributes) for comprehensiveness and applicability by 5 independent members of the team (Version 1.0). This was refined further by AFRO and an evidence based draft set of 15 attributes of scalability was thus derived (Version 2). A regional consultation was subsequently undertaken with independent experts, comprised of academics, practitioners, advocates, or policymakers, using a Delphi technique. The key objective was to validate a regional framework for scaling health interventions in Africa (AFROSAF), which will act as a regional product that can guide member states.Results
By the end of the consultations, the AFRO SAF was refined to include succinct and coherent attributes, as well as descriptions. The expert groups applied the framework to the health services interventions compiled1, that are disaggregated by age cohort and public health functions.- For full reference of the development process, please see here [LINK to full document in PDF]
- For full reference to the compendium of interventions, please visit here
- For full information on scalability analysis, please see here [LINK – analysis page]
