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 well-being. At present, the priority-setting process is based on one or more of the three following attributes of interventions when compared with alternatives:

• Effectiveness – the intervention is best able to achieve the desired result
• Equity – the intervention is better at targeting vulnerable beneficiaries
• Efficiency – the intervention represents better values 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.

What is the AFROSAF?

The African Scalability Assessment Framework (AFROSAF) is an evidence-based and user-centered framework designed to act as a regional product that can guide member states in determining the scalability of an evidence-based health intervention in Africa.

The framework was developed, validated and tested by the WHO Regional Office for Africa through rigorous, systematic and evidence-based scientific process. The involves knowledge syntheses, multistakeholder consensus exercise, and a five-day deliberative workshop with end-users.

This framework was applied to 371 evidence-based health interventions identified by the WHO Regional Office for Africa.

The AFROSAF consists of 14 attributes grouped into nine scalability components:

1. Health Need
2. Development Process
3. Intervention Content
4. Political Context
5. Evidence for Impact
6. Resource Availability
7. Target Unit
8. Scalability Setting
9. Sustainability at Scale