Nine Elements for Successful Scale-up

© 2008 Dana Pitts, Courtesy of PhotoshareThe authors of Scaling up mobile health: elements necessary for the successful scale-up of mHealth in developing countries (a paper commissioned by Advanced Development for Africa, Actevis Consulting Group) identify nine best practices, drawn from case studies and expert interviews, for ensuring scalability of an mHealth project. Many of these practices are discussed in depth throughout the Guide, and they are paraphrased here:

  1. Consider sustainability and scalability of the program from the beginning. Make sure the hardware and software selected for the pilot program can be used on a broader scale. Formulate a long-term plan for financing. Continually monitor and evaluate the process and outcomes of the intervention.
  2. Assess the needs and demands of the target audience and be sure to understand local health priorities and the local technological, political, and programmatic landscape. Then plan and design the intervention with the local conditions, environment, stakeholders, and barriers in mind.
  3. Identify existing similar mHealth efforts. Rather than replicating work that has already been done, collaborate with other organizations working toward similar goals. Forge linkages with other mHealth programs in order to learn from their successes and failures. Leveraging existing knowledge and platforms will increase the efficacy of your program and help attract financial support and partnerships for scale-up.
  4. Educate and engage end users and target beneficiaries throughout the mHealth development process to foster buy-in. These stakeholders might include community and traditional leaders, community health workers, and community members. Encourage local stakeholders to take leadership roles in the development of the mHealth solution.
  5. Make sure the mHealth program is aligned with local and national health priorities and that it is compatible with existing health information systems. If the pilot is successful, it will be easy to justify integrating the program into the national health system.
  6. Take steps to foster buy-in from government, communities, and local health systems from the beginning of the planning process. Include all stakeholders in the planning and decision making process from beginning. Meet with as many government officials, community organizations, and local leaders as possible. Systematically monitor and evaluate the process and outcomes to show key stakeholders the costs, benefits, and other impacts of the program.
  7. Work closely with local implementation partners. This will help ensure the content and format are user-friendly and accessible to target beneficiaries. Local partners can help you incorporate local language, values, and themes into the mHealth solution and make sure training and social marketing efforts adequately address local information needs.
  8. Form strategic partnerships to support scale-up. Partners might include, for example, mobile network operators, technology companies, ministries of health, pharmaceutical or other consumer goods companies, and more.
  9. Continually and systematically monitor and evaluate the mHealth intervention to assess its impact and identify necessary adjustments. Use meaningful, measureable indicators that will inform the decision about whether to scale up. Be sure there is enough flexibility in your implementation process to allow the program to adapt to changing needs, implementation challenges, technological realities, or other issues revealed by monitoring and evaluation (M&E) data.