Scaling up

This is the final post of a three part series of guest blogs based on writings provided by Maurits van Pelt, Director of MoPoTsyo Patient Information Centre in Cambodia. Collectively these writings provide a roadmap for scaling up peer educator networks and developing sustainability for what is now still an intervention organized and facilitated by a Cambodian NGO. Part 1 focused on developing a Niche and Demonstrating value. Part 2 Focused on Integration. Part 3 focuses on the scaling up process.

Why do many organizations fail to scale up interventions?
There have been many attempts to scale up interventions in the health sector by engaging with the community that have not been successful. The reasons for these failures in low resource contexts are multiple and complex (Bloom & Ainsworth, 2010). Often times there is not a lasting community engagement even when resources are made available because training is either too short or handed down as a set of technical instructions from the service supply side to community representatives without appropriate explanation. A top-down inflexible package that is neither adapted nor responsive to the needs of the local community can be delivered but the results will frequently disappoint.

MoPo Tsyo’s approaches to scaling up
MoPoTsyo’s has experienced successful growth thus far by focusing on replication and selecting candidates from new areas to receive extensive training. These candidates travel and stay several weeks in places where they can learn and interact with others that have been successful. This experience helps prepare candidates for travel to places where there is a need for training and supervision of others.

Once networks are mature, selected members play a key role in helping to create other networks. Some of them grow to become managers and are involved in organization, negotiation and representation. The organization at the central level lets members grow and take on more responsibility but also adds people with special skills that cannot be found among the staff. Continuous learning and standardization is achieved through a centralization of information at the NGO’s relatively small office in Phnom Penh. There are no plans to establish physical infrastructure in the provinces outside the existing public health infrastructure. The organization is aiming to coordinate and finance its growth by intensifying its partnership with the existing public health care system where it can without losing quality, effectiveness, efficiency and responsiveness.


Bibliography

Bloom, G., & Ainsworth, P. (2010). Beyond Scaling Up: pathways to universal access to health services. Sussex UK. Retrieved from http:\\www.steps-centre.org\publications.