What happens when you “scale up” health services to try to provide widespread coverage in a region or country? The “Beyond Scaling Up” panel at the Health Systems Research symposium last week posed this question. The speakers answered with success stories from Brazil, China and Nigeria; some cautionary tales from attempts to “scale up” that have gone wrong; and a warning that health programmes need to be aware of lots of factors which can put a spanner in the works:

“There has been a shift from absolute scarcity to problems with safety, quality and cost with changing patterns of inequality, the introduction of new technologies and institutional arrangements, the rise of patient and citizen movements and mixed systems.”

Kate Hawkins has written a post reporting on the session on the Future Health Systems blog.

Links

> Future Health Systems blog: Exploring the spread and scale up of health interventions and service coverage
> Beyond Scaling Up panel: details
> STEPS Centre: Beyond Scaling Up working paper & briefing