Prepare To Scale Up

Summary of lessons learned

To scale up successfully, management and coordination systems must be carefully designed so that information, human, and financial resources can be used most effectively to reach greater numbers of families in need.
Interinstitutional coordination is key to the success of the scaling-up effort. The coordination with the Ministry of Health is not just at the executive level, but negotiation and action takes place at the regional, district, sector, and area levels as well.
Training and technical assistance in program methods must be provided and a variety of media used to spread the methodology, tools, and lessons learned on a regional, national, or international level. Establish a small team that will provide technical assistance and training to other organizations or communities that choose to implement the program.
The technical personnel in charge of coordinating with partner agencies should possess the following characteristics: high level of skill in nonformal education methodologies, ability to speak the regional language, exceptional interpersonal skills so that they are capable of obtaining the acceptance of the communities, and commitment to stay with the project for at least two years.
It is important to work with communities that participated in the successful initial pilot sites to establish them as “living universities” where others who want to learn the methodology can go to get hands-on training and experience in the field.
Implementing partners should disseminate knowledge of successful methods and tools through regional or international workshops or conferences; introduce training tools at workshops where participants can practice using them; and establish support groups of trainees so that they can learn from each other’s experiences and provide assistance when implementation does not go exactly as planned.
Organizations will learn what works and does not work through their own experience in the field. The benefit of having on-the-ground technical assistance from organizations that have successfully implemented the methodology is that these lessons have often already been learned and could have been shared with new partners.
Mechanisms should be developed to aid communities that are interested in replicating or adapting the methodology or using the tools. Contact information at the end of the television or radio programs or print stories can lead the audience to a website or contact address for more information. Media centers and clearinghouse experience will prove invaluable in this effort.
The parameters of any partnerships should be defined at the beginning. If possible, make the terms as clear to both parties as possible by forging a written Memorandum of Agreement or Understanding
Partners need to work from the same paradigm. Both organizations should operate on the principle that workable and sustainable community health activities should be designed within the context of a community-managed health system and not just from the point of view of the health providers.
Partners must have mutual trust and be open and honest with each other to survive. They should recognize mutually beneficial strengths and help each other overcome weaknesses, and they should seize every opportunity to strengthen the partnership through other activities or projects even if they are outside the bounds of the partnership.
Inter-organizational learning involves not only sharing each other’s special skills but also the pool of technical resources that may be made available to each partner.