9.G. Workshop: Evaluation of scale-up of health systems interventions: what and how? Lessons for scale-up projects

Abstract

Abstract Objectives Non-communicable diseases (NCD) are a major challenge for health systems across the globe. Although effective interventions for prevention, detection and control exist, these do not reach all people in need, especially the poor and most vulnerable. Scale-up strategies are developed to increase universal access to those interventions, addressing demand-side and supply-side barriers and to facilitate integration in the health system. While there are useful frameworks to conceptualise and operationalise scale-up of NCD interventions, there is a knowledge gap on what and how to evaluate. This session addresses that knowledge gap, presenting evaluation methods for scale-up from four large multi-country research projects. The objectives are: To increase knowledge on four dimensions of scale-up evaluation: 1) contextualisation of methods; 2) implementation evaluation; 3) cost-evaluation and 4) use of health information systemsTo present methods and results of implementation research on NCDs as an example for other chronic diseasesTo illustrate how contextualisation, implementation and evaluation varies across different stages of scale-upTo stimulate learning by experience through small-group discussion with session participants This workshop provides added value through the four coherent presentations combined with small group interactions on the same topics. It allows the audience to link the case study lessons to their own research and wider application. Format Four different elements of scale-up evaluation are addressed: 1) Contextualisation of evaluation methods from a common framework; 2) Implementation evaluation at operational level; 3) Cost-evaluation of NCD interventions; and 4) Large-scale evaluation through routine health information systems (HIS). Case studies from four large-scale Horizon2020 funded research projects in 14 countries in Europe, Africa and Asia will be presented, each case focusing on one dimension. Cross-cutting themes of adaptation and transferability of methods will also be addressed. After the presentations, there will be an interactive session to promote experience-based learning in small-group discussions. Presentations Self-Management Approach and Reciprocal Learning for Type 2 Diabetes (SMART2D)Scaling-up Packages of Interventions for cardiovascular disease prevention in Europe and Sub-Saharan Africa (SPICES)Scaling-Up NCD Interventions in South-East Asia (SUNI-SEA)The Scale-Up of Diabetes and Hypertension Care (SCUBY) The presentations will provide the introduction to subsequent small-table discussions, around the following questions: How to measure and monitor implementation and outcome of intervention scale-up?How to generate transferrable lessons from cross-country studies?How to conduct cross-setting evaluation of the effect and cost of NCD interventions? Key messages The global scale-up of NCD interventions calls for robust evaluation methods of effect, implementation and cost. Evaluation methods need to be fit to the country context and health information systems.